MRI of the Pituitary Gland Bonneville

Visit to download the full and correct content document:

https://textbookfull.com/product/mri-of-the-pituitary-gland-bonneville/
More products digital (pdf, epub, mobi) instant
download maybe you interests ...

MRI and CT of the Female Pelvis Forstner

https://textbookfull.com/product/mri-and-ct-of-the-female-pelvis-
forstner/

Fundamentals of Body MRI Christopher Roth

https://textbookfull.com/product/fundamentals-of-body-mri-
christopher-roth/

Quantitative MRI of the Brain : Principles of Physical

Measurement, Second edition Cercignani

https://textbookfull.com/product/quantitative-mri-of-the-brain-
principles-of-physical-measurement-second-edition-cercignani/

Salivary Gland Cancer From Diagnosis to Tailored

Treatment Lisa Licitra

https://textbookfull.com/product/salivary-gland-cancer-from-
diagnosis-to-tailored-treatment-lisa-licitra/
Musculoskeletal MRI 3rd Edition Nancy Major

https://textbookfull.com/product/musculoskeletal-mri-3rd-edition-
nancy-major/

MRI Of Fetal And Maternal Diseases In Pregnancy

Gabriele Masselli

https://textbookfull.com/product/mri-of-fetal-and-maternal-
diseases-in-pregnancy-gabriele-masselli/

Breast MRI Teaching Atlas 1st Edition Richard Ha

https://textbookfull.com/product/breast-mri-teaching-atlas-1st-
edition-richard-ha/

Lake Bonneville A Scientific Update 1st Edition Charles

G. Oviatt And John F. Shroder (Eds.)

https://textbookfull.com/product/lake-bonneville-a-scientific-
update-1st-edition-charles-g-oviatt-and-john-f-shroder-eds/

Biophysics and biochemistry of cartilage by nmr and mri

1st Edition Yang Xia

https://textbookfull.com/product/biophysics-and-biochemistry-of-
cartilage-by-nmr-and-mri-1st-edition-yang-xia/
Jean-François Bonneville, Fabrice Bonneville, Françoise Cattin and
Sonia Nagi

MRI of the Pituitary Gland

Jean-François Bonneville
Department of Endocrinology, CHU Sart-Tilman, Liège, Belgium

Fabrice Bonneville
Department of Neuroradiology, University Hospital Paul Sabatier, Toulouse,
France

Françoise Cattin
Department of Neuroradiology and Endovascular Therapy, University
Hospital of Besançon, Besançon, France

Sonia Nagi
Faculty of Medicine National Institute of Neurology, University of Tunis El
Manar, Tunis, Tunisia

ISBN 978-3-319-29041-6 e-ISBN 978-3-319-29043-0

DOI 10.1007/978-3-319-29043-0

Library of Congress Control Number: 2016935498

© Springer International Publishing Switzerland 2016

This Springer imprint is published by Springer Nature

This work is subject to copyright. All rights are reserved by the

Publisher, whether the whole or part of the material is concerned,
specifically the rights of translation, reprinting, reuse of illustrations,
recitation, broadcasting, reproduction on microfilms or in any other
physical way, and transmission or information storage and retrieval,
electronic adaptation, computer software, or by similar or dissimilar
methodology now known or hereafter developed.
The use of general descriptive names, registered names,
trademarks, service marks, etc. in this publication does not imply,
even in the absence of a specific statement, that such names are
exempt from the relevant protective laws and regulations and
therefore free for general use.

The publisher, the authors and the editors are safe to assume that
the advice and information in this book are believed to be true and
accurate at the date of publication. Neither the publisher nor the
authors or the editors give a warranty, express or implied, with
respect to the material contained herein or for any errors or
omissions that may have been made.

Printed on acid-free paper

The registered company is Springer International Publishing AG

Switzerland
Foreword
The pituitary is a tiny and fascinating gland of extreme importance
biologically, surrounded by an array of vital structures. Correct
decision-making about the pituitary is of the utmost clinical
importance. While we can infer pathology from hormonal profiles
and clinical symptoms, neuroradiological images often provide us
with the key information in planning correct treatment. Thankfully,
this potentially confusing experience for the uninitiated is made far
easier with the publication of MRI of the Pituitary Gland by Prof.
Jean-Francois Bonneville and his co-authors. This new book is
aimed at an audience far wider than just neuroradiologists,
although they too will find much of interest therein. It is for all of
us, particularly endocrinologists, who find ourselves faced regularly
with clinical problems that may be related to pituitary pathology.
The book covers all of the major topics of importance, building from
the foundations of normal appearance and characteristics of the
pituitary and surrounding structures to cover tumors and related
disorders. It is remarkable how many differential diagnoses must be
entertained when assessing disorders of pituitary appearance on
MRI. The pituitary gland is not only the site of primary pathologies
but also can act as an important site of secondary systemic
pathology of immune, inflammatory, or infectious diseases. Prof.
Bonneville guides us through these various possibilities and
carefully shows us how they may be distinguished from one another.
Furthermore, he integrates his long experience as a diagnostician
and researcher by adding information on how the appearance of
pituitary tumors can determine aspects of their clinical behavior
(e.g., acromegaly). Prof. Bonneville is an acknowledged world-
leading authority in neuroradiology of the pituitary and surrounding
structures who gained this experience through a lifetime of clinical
and teaching work in France. Since he retired from his hospital
position in France, happily he has agreed to continue sharing his
experience with us having swapped the Jura for the Ardennes of
Belgium. So I have now had the personal pleasure of benefiting
from his input on clinical neuroradiology on my own patients and
undertaking new research working together as colleagues in Liège. I
was delighted on many occasions to attend lectures and courses
given by Prof. Bonneville on the topic of pituitary neuroradiology.
These events never fail to be informative and interesting, given his
wide breadth of knowledge and experience. However, these are not
entirely relaxed encounters, as Prof. Bonneville always ends with a
quiz on what he has just been teaching and illustrating. I have often
seen quite experienced senior endocrinologists squirming under
questioning when interpreting pituitary imaging! This is, for me, one
of the important reasons why this book is so welcome. Pituitary
neuroradiology is complex and there are many pitfalls of which we
can become victims. With this book we can learn to identify those
elements that can confound correct interpretations, and with the
copious illustrations and images we can visualize the pathology
clearly and memorably.
Albert Beckers (Chief)
Preface
Magnetic resonance imaging (MRI) is currently considered as a
major keystone of the diagnosis of diseases of the hypothalamic-
hypophyseal region. However, the relatively small size of the
pituitary gland, its deep location at the skull base, and the
numerous physiological variants present in this area impede the
precise assessment of the anatomical structures and, particularly, of
the pituitary gland itself.
The diagnosis of the often tiny lesions of this region, such as
pituitary microadenomas, is thus difficult if the MRI technology is
not optimized and if potential artifacts and traps are not recognized.
Advanced MRI technology is able not only to depict small lesions
with greater reliability, but also helps in the differential diagnosis of
large tumors, particularly for which defining the presence or
absence of invasion of the cavernous sinus is an important task.
This book describes and illustrates the role of MRI in the
diagnosis of the different lesions of the sellar region, from the
common prolactinoma, to the nonfunctioning adenoma and the
Rathke cleft cyst, to the less frequent lymphocytic hypophysitis or
pituitary corticotroph adenoma in Cushing disease, and other
neoplastic and non-neoplastic entities.
Finally, the book emphasizes the necessity of adapting the MRI
sequences to the symptoms of each particular patient and of
working in close collaboration with all specialists involved in the
pathology of the sellar area.
Jean-François Bonneville
Fabrice Bonneville
Françoise Cattin
Sonia Nagi
Abbreviations
3D TOF 3-dimensional time-of-flight
AC arachnoid cyst
ACTH adrenocorticotropic hormone
ADC apparent diffusion coefficient
ADH antidiuretic hormone
AIP aryl hydrocarbon receptor interacting protein
CE T1WI contrast-enhanced T1-weighted image
CISS constructive interference in steady state
CNS central nervous system
CPC craniopharyngeal canal
CSF cerebrospinal fluid
CT computed tomography
DWI diffusion-weighted image
FLAIR fluid-attenuated inversion recovery
FSH follicle-stimulating hormone
GCT granular cell tumor
GE gradient echo
GH growth hormone
LH luteinizing hormone
MEN 1 multiple endocrine neoplasia type 1
MRA magnetic resonance angiography
MRI magnetic resonance imaging
PCNSL primary central nervous system lymphoma
rCBV relative cerebral blood volume
RCC Rathke cleft cyst
ROI region of interest
T1WI T1-weighted image
T2WI T2-weighted image
TSH thyroid-stimulating hormone
WHO World Health Organization
Contents
1 MRI Technique and Radiological Anatomy of the Pituitary
Gland

1.​1 Basic MRI Sequences

1.​2 Additional Sequences

1.​3 Advanced MRI Techniques

1.​4 Radiological Anatomy

1.​4.​1 The Anterior Lobe of the Pituitary Gland

1.​4.​2 The Pituitary Stalk

1.​4.​3 The Posterior Lobe of the Pituitary Gland

1.​4.​4 The Cavernous Sinus

2 Traps and Artifacts

3 Small Sella and Convex Pituitary Gland

4 Nonfunctioning Pituitary Macroadenoma:​General Points

5 Prolactinoma in Women

6 Prolactinoma and Dopamine Agonists

7 Normal Pituitary Gland and Pregnancy

8 Pituitary Tumors and Pregnancy

9 Prolactinoma in Men
10 Aggressive Pituitary Adenoma

11 Cavernous Sinus Invasion

12 Hemorrhagic Pituitary Adenoma

13 Pituitary Apoplexy

14 Acromegaly

15 Cushing Disease

16 Silent Corticotroph Pituitary Adenoma

17 Pituitary Carcinoma

18 Ectopic Pituitary Adenoma

19 Rathke Cleft Cyst:​Asymptomatic

20 Rathke Cleft Cyst:​Symptomatic and Complicated

21 Pituitary Adenoma and Concomitant Sellar Lesions

22 Craniopharyngiom​a

23 Pre- and Suprasellar Meningiomas

24 Cavernous Sinus Meningioma

25 Intraoperative MRI

26 The Early Postoperative Sella

27 The Late Postoperative Sella

28 Complications of Pituitary Surgery

29 The Pituitary Gland After Radiation Therapy

30 Chiasmatic and Hypothalamic Gliomas

31 Suprasellar Germinoma

32 Melanoma

33 Pituitary Metastases

34 Sellar and Suprasellar Lymphoma

35 Cavernous Sinus Lesions

35.​1 Aneurysm

35.​2 Cavernous Hemangioma

35.​3 Cavernous Sinus Thrombosis

35.​4 Tolosa-Hunt Syndrome

35.​5 Trigeminal Schwannoma

35.​6 ENT Lesions

35.​7 Metastases

36 Primary Neurohypophyseal​Glial Tumors

37 Chordoma and Chondroma/​Chondrosarcoma

38 Hamartoma of the Tuber Cinereum

39 Sphenoid Mucocele

40 Primary Hypophysitis

41 Pituitary in Systemic Diseases

41.​1 Sarcoidosis
 41.​2 Histiocytosis

41.​3 Wegener Granulomatosis

41.​4 Crohn Disease

41.​5 IgG4-Associated Multifocal Systemic Fibrosis

42 Pituitary Abscess

43 Empty Sella

44 Sheehan Syndrome

45 Pituitary Hyperplasia and Primary Hypothyroidism

46 Intracranial Hypotension Syndrome

47 Pituitary Hemochromatosis

48 Arachnoid Cyst

49 Epidermoid Cyst

50 Dermoid Cyst

51 Neurenteric Cyst

52 “Incidentalomas”.​Posterior Pituitary Cyst

53 The Ectopic Posterior Lobe

54 Lipoma

55 Rare T1 Hyperintensities​of the Anterior Pituitary Gland

56 Craniopharyngeal​Canal and Meningocele

57 Pituitary Gland Duplication and Triplication

58 The Sellar Spine

59 Vascular Variants of the Sellar Region

59.​1 Persistent Trigeminal Artery

59.​2 Intrasphenoidal Internal Carotid Artery

59.​3 Inferior Intercavernous Sinus

59.​4 Intrasellar Internal Carotid Artery

60 Aneurysms

61 Trauma of the Pituitary Region

Index
Collaborators
Michael Buchfelder, MD, PhD
Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany

Cyrine Drissi
Faculty of Medicine, University of Tunis El Manar, Department of
Neuroradiology, Institut National de Neurologie, Tunis, Tunisia

Julie Kreutz
Department of Radiology, Centre Hospitalier Universitaire de Liège, Liège,
Belgique

Maha Mahmoud
Faculty of Medicine, University of Tunis El Manar, Department of
Neuroradiology, Institut National de Neurologie, Tunis, Tunisia

Iulia Potorac
Department of Endocrinology, Centre Hospitalier Universitaire de Liège,
Liège, Belgique

Sven-Martin Schlaffer, MD
Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen,
Germany
© Springer International Publishing Switzerland 2016
Jean-François Bonneville, Fabrice Bonneville, Françoise Cattin and Sonia Nagi,
MRI of the Pituitary Gland, DOI 10.1007/978-3-319-29043-0_1

1. MRI Technique and Radiological

Anatomy of the Pituitary Gland
Françoise Cattin1
(1) Department of Neuroradiology and Endovascular Therapy, University
Hospital of Besançon, Besançon, France

1.1 Basic MRI Sequences

Three basic sequences are indicated in all clinical situations. These
sequences are often adequate for the diagnosis, particularly in the
search for microprolactinomas. Additional sequences may be
obtained according to the clinical and biological status and after
reading the basic sequences.
Sagittal T1W sequence focused on the pituitary region
constitutes the first step of the MR examination: this sequence is
rarely informative in the diagnosis of intrasellar lesions, but allows
one to draw an anatomical plane, for example the sub-callosal
plane, which will allow perfect reproducibility of the coronal cuts for
serial MRI (Fig. 1.1). This sagittal T1W sequence is essential in the
evaluation of lesions with suprasellar extension to analyze the
anatomical surroundings. At 3.0 T, sagittal spin echo T1WI are
obtained with the following parameters: TR/TE: 425/14, BW: 31,25
kHz, FOV/matrix: 23 cm/416 × 256, 3.0 mm thk/0.3sp, 3NEX, AT:
5:29. Standard protocol includes a coronal fast spin-echo T2W
sequence (TR/TE: 3500/140, BW: 25 kHz, FOV/matrix: 20 cm/384
× 384, 2 mm thk/0.2sp, 4 NEX, AT: 5:15 and a coronal spin-echo
T1W sequence (TR/TE: 700/14, BW: 31,25, FOV/matrix: 23 cm/416
× 256, 3 mm thk/0.2sp, 3 NEX, AT: 6:53) (Fig. 1.2).

Fig. 1.1 Sagittal T1WI. The coronal cuts are obtained perpendicularly to the sub-callosal
plane
Fig. 1.2 Normal pituitary gland. (a, b) Sagittal T1 and CE T1WIs. (c, d) Coronal T1 and
T2 WIs at the anterior part of the pituitary gland. (e, f) Coronal T1 and T2 WIs, 2 mm
posterior to (c) and (d). Anterior lobe (curved arrow). Posterior lobe (thick arrow).
Pituitary stalk (thin arrow). On T2WI, a flow artifact in the suprasellar cistern blurs the
pituitary stalk. Optic chiasm (asterisk). After gadolinium injection (b), enhancement of
anterior lobe, pituitary stalk, and tuber cinereum (open arrow)
When an intrasellar lesion is suspected on the sequences
without contrast, the diagnosis can be confirmed by the realization
of coronal T1WI after gadolinium injection (CE T1WI). A low dose of
contrast medium (0.05 mmol/k) is recommended to avoid a too
intense enhancement, which may hide a small intraglandular lesion.
Nevertheless, it is our own policy to spare gadolinium
administration when the clinical situation is clear and confirmed by
the noncontrast T1 and T2WI, for instance when searching for
microprolactinomas. Delayed imaging 45 min after gadolinium
injection can have some interest, mainly in Cushing disease, in
revealing a very small microadenoma (“picoadenoma”) when T1,
T2, and CE T1WI are not informative.
In the case of a lesion with suprasellar extension, coronal and
sagittal T1W sequence after gadolinium injection and, if necessary,
a 3D gradient echo T1W acquisition with gadolinium for
neurosurgical planning are performed.
1.2 Additional Sequences
Axial TWI, preferentially with fat saturation is the best sequence to
evaluate the storage of vasopressin and is thus highly
recommended for the exploration of diabetes insipidus. This
sequence will also be extremely useful to consolidate the diagnosis
of intrasellar Rathke cleft cyst even when associated with pituitary
microadenoma.
In the exploration of Cushing disease, if the standard sequences
including the sequences after gadolinium injection are negative, a
dynamic imaging is obtained (Fig. 1.3). A 3D T1W gradient-echo
sequence with inframillimetric section thickness may demonstrate a
tiny ACTH-secreting pituitary microadenoma.
Fig. 1.3 Dynamic MRI of the normal pituitary gland. (a) Before contrast injection. (b)
About 30 s later, opacification of the pituitary stalk and the secondary capillary bed
(arrow). (c) At 60 s, the enhancement of the pituitary gland is intense and homogeneous.
(d–f) Slow decrease of enhancement intensity
3D TOF MRA is useful in the lesions affecting the cavernous
sinus, particularly in the diagnosis of aneurysm of the
intracavernous internal carotid artery, ectasic carotid siphons, and
dural fistula, or to confirm anatomical variations such as persistent
trigeminal artery.

1.3 Advanced MRI Techniques

Diffusion imaging, perfusion imaging, and proton MR spectroscopy
(MRs) can be helpful in differentiating various types of lesions
involving pituitary gland and hypothalamus. These techniques
require the positioning of a region of interest (ROI) with a sufficient
size, and thus may have a role only in the evaluation of large
lesions.
Diffusion imaging can have an interest in early detection of
pituitary infarction or pituitary apoplexy and in differentiation of
abscess from hemorrhage, the ADC value being considerably
decreased in pituitary ischemia and abscess. The relationship
between diffusion imaging and apparent diffusion coefficient on one
hand, and consistency of the pituitary adenoma on the other, is
controversial. For some authors, macroadenomas with hypersignal
on diffusion imaging and a low ADC value present a soft
consistency, while those with hyposignal and a high ADC value are
firmer: these data may have been useful for the neurosurgeon but
are not confirmed in recent studies. It is generally admitted today
that there is no correlation between the ADC and both the
consistency and secretory type of the pituitary adenoma.
MRs has a limited interest in the diagnosis of pituitary lesions.
However, some MRs patterns can help to confirm a diagnosis
evoked on standard sequences. Hypothalamic gliomas demonstrate
increased choline peak and decreased N-acetylaspartate (NAA)
peak. In craniopharyngiomas and germinomas, a high level of lipids
is usually observed with only some traces of other metabolites.
Hypothalamic hamartomas are characterized by decreased NAA and
increased myoinositol. Pituitary adenomas can show only a choline
peak; in the case of hemorrhagic complications, no metabolites are
found.

1.4 Radiological Anatomy

1.4.1 The Anterior Lobe of the Pituitary Gland
In adults, the upper pole of the anterior lobe can be plane, concave,
or convex. The signal of the normal anterior lobe is homogeneous,
similar to that of the white matter of the temporal lobe on T1WI. A
possible discrepancy between the size of the sella turcica and that
of the pituitary gland can lead to mistakes. When the sella turcica is
unusually small, the pituitary gland may appear bulky, overflowing
frankly the theoretical plan of the sellar diaphragm in the manner of
a brioche leaving its mold.
The size and morphology of the anterior lobe of the pituitary
gland are variable according to age and sex (Fig. 1.4).
Fig. 1.4 Pituitary gland in children, sagittal T1WIs. (a) 5-day-old newborn. Round and
globulous pituitary gland. Anterior pituitary is markedly hyperintense and
indistinguishable from the posterior lobe. (b) 12-day-old newborn. The convex anterior
pituitary is hyperintense but slightly less so than the posterior pituitary. (c) 7-week-old
infant. Convex upper pole of the pituitary gland. Hyperintensity of the anterior pituitary is
less marked than that of the posterior pituitary. (d) 21-month-old child. The anterior
pituitary gland is no more hyperintense. The posterior lobe is proportionally larger than in
adult. (e) 7-year-old boy. No change when compared with (d). (f) 15-year-old girl.
Normal convex pituitary gland of the adolescent
In the newborn and up to the end of the second month of life,
the pituitary gland is rounder and larger than in the older child : 63
% of infants aged less than 1 month present a convex pituitary
gland against only 4 % of the children older than 2 months.
Before 2 months, the anterior lobe of the pituitary gland appears
hyperintense on T1WIin 75 % of the cases if compared with the
brainstem. This hypersignal is never observed beyond the second
month. This hypersignal is related to an increase of endoplasmic
reticulum and intense activity of protein synthesis. The relatively
large size of the pituitary gland at birth is correlated with
hyperplasia of prolactin cells, an intense endocrinal activity and an
important protein synthesis. Lack of high signal or discovery of a
small pituitary gland in a neonate should alert one to the possibility
of pituitary malformation or dysfunction such as hypoglycemia. The
usual hypersignal of the posterior lobe on T1WI is detectable from
birth, so that the pituitary gland of the newborn appears entirely
hyperintense.
Beyond 2 months of age, the pituitary gland tends to flatten and
the signal of the anterior lobe becomes similar to that seen in the
adult; the posterior lobe only remains hyperintense on T1WI. The
height of the pituitary gland measured on the midsagittal plane is
usually between 2 and 6 mm, and there is no difference between
males and females.
At puberty, a physiological hypertrophy of the gland is visible in
females and males, but is definitively more marked in females.
Before 12 years, the pituitary gland does not measure more than 6
mm in height. At puberty, a pituitary gland height from 8 to 10 mm
is not rare in females. In males, a height higher than 7 mm must be
regarded as suspect. The upper pole of the pituitary gland is
upwardly convex in 56 % of females at puberty versus 18 % in the
other age groups. Thus, the increase in volume and T1 hypersignal
of the pituitary gland occurs during the maximal hormonal secretion
period.
In women less than 50 years old, the pituitary gland is larger
than in men and is more often upwardly convex. The height of the
pituitary gland is more than 7 mm in 1 out of 4 women; between 20
and 40 years, 58 % of women have a pituitary gland more than 7
mm in height. In men, the height of the pituitary gland decreases
regularly between 20 and 65 years; only 10 % of men have a
pituitary gland more than 6 mm in height, and only 3 % a pituitary
height greater than 7 mm. In the elderly population, interstitial and
perivascular fibrosis can lead to an empty sella, most of the time
without major influence on pituitary function. Small deposits of
amyloid and iron may be observed.
After gadolinium injection, the enhancement of the anterior lobe
of the pituitary gland is usually intense and homogeneous. On
dynamic imaging, the anterior lobe is opacified later than in the
posterior lobe because of its predominantly portal blood supply.
Temporal resolution of dynamic imaging of the pituitary gland is
longer than that of a dynamic CT scan. The first image is obtained
20–30 s after the beginning of gadolinium injection, and shows
opacification of the pituitary stalk and upper part of the pituitary
gland corresponding to the secondary pituitary capillary bed (“tuft”)
and the adjacent glandular parenchyma already contaminated by
gadolinium. On the second image at 40–60 s after gadolinium, the
pituitary gland is intensely and homogeneously opacified, after
which a slow decrease of intensity is observed.

1.4.2 The Pituitary Stalk

Under normal conditions, the diameter of the upper part of the
pituitary stalk is thicker than the lower part. Thus, a tube-like
pituitary stalk may be an indicator of an abnormal pituitary stalk. A
physiological elongation of the infundibular recess of the third
ventricle can simulate an enlarged stalk. The maximal diameter of
the pituitary stalk measured on the axial plane is about 3 mm. The
pituitary stalk is not always vertical: a more or less marked tilting is
not infrequent. This anatomical variation confirms that the
displacement of the pituitary stalk is not a highly reliable sign for
the diagnosis of pituitary microadenoma.

1.4.3 The Posterior Lobe of the Pituitary Gland

It is currently well established that the hypersignal visible on T1WI
and located at the posterior part of the sella turcica corresponds to
the storage of vasopressin in the posterior lobe. This T1 hypersignal
indicates a normal functional state of the posterior lobe. The T1
hypersignal disappears in patients with central diabetes insipidus.
An exact explanation of this T1 hypersignal is as yet not available.
For some authors, the hypersignal is in relation with lipidic droplets
present in the pituicytes. For others, the hypersignal corresponds to
the antidiuretic hormone (ADH) granules or to a complex of ADH
and neurophysin. A third theory states that the hypersignal is
related to the presence of phospholipids in the posterior lobe of the
pituitary gland.
Lack of visualization of the posterior lobe on the sagittal plane in
normal subjects is generally due to an inappropriate technique, or
to anatomical reasons such as a fatty or thick dorsum sellae.
Realization of axial cuts allows one to reach a rate of detection of
the posterior lobe close to 100 %. Classically, the posterior lobe is
described on sagittal images as a hyperintense and homogeneous
structure with regular anterior convexity, in contact with the dorsum
sellae (Fig. 1.5). In fact, this pattern is not always seen:
heterogeneous signal and irregularities of the anterior aspect of the
posterior lobe, which could suggest an irregular distribution of the
neurosecretory granules, are frequently observed. In the elderly, the
signal of the posterior lobe is less intense and often heterogeneous,
as a result of the persistently raised plasmatic osmolality (Fig. 1.6).
For the same reason, lesser T1 hyperintensity can be observed
during pregnancy, in patients undergoing hemodialysis or with
uncontrolled diabetes mellitus, severe anorexia nervosa, and in a
stressed condition.
Fig. 1.5 Normal posterior lobe of the pituitary gland. (a) Axial Fat-Sat T1WI at 3.0 T.
Suppression of the fat signal of the dorsum sellae allows good delineation of the
hyperintense posterior lobe (arrow). (b) Axial T1WI at 1.5 T. Lateralized posterior lobe.
(c) Axial CT scan, bone window demonstrating the imprint of the posterior lobe in the
dorsum sellae (fossula hypophyseos) (arrow)
Another random document with
no related content on Scribd:
 Thus, even at Medîna, sedition spread,
and from thence messages reached the Aly expostulates with
provinces that the sword would soon be Othmân.
needed there at home, rather than in foreign parts. So general was
the contagion that but few are named as having escaped it.[469]
Moved by the leading citizens, Aly repaired to Othmân and said:
—‘The people bid me expostulate with thee. Yet what can I say to
thee—son-in-law as thou wast of the Prophet and his bosom friend—
that thou already knowest not as well as I? The way lieth plain and
wide before thee; but thine eyes are blinded that thou canst not see
it. If blood be once shed, it will not cease to flow until the Day of
Judgment. Right will be blotted out, and treason rage like the
foaming waves of the sea.’ Othmân complained, and not without
reason, of the unfriendly attitude assumed by Aly himself. ‘For my
own part,’ he said, ‘I have done my best; and as for the men ye
speak of, did not Omar himself appoint Moghîra to Kûfa; and if Ibn
Aámir be my kinsman, is he any the worse for that?’ ‘No,’ replied Aly;
‘but Omar kept his lieutenants in order, and when they did wrong he
punished them; whereas thou treatest them softly, because they are
thy kinsmen.’[470] ‘And Muâvia, too,’ continued the Caliph; ‘it was
Omar who appointed him to Syria.’ ‘Yes,’ answered Aly; ‘but I swear
that even Omar’s slaves did not stand so much in awe of their
master, as did Muâvia. But now he doth whatever he pleaseth, and
saith It is Othmân. And thou, knowing it all, leavest him alone!’ So
saying, Aly turned and went his way.
As Aly’s message professed to come
from the people, Othmân went straightway Othmân appeals to the
to the pulpit and addressed the multitude people.
then assembled for prayer in the Great Mosque. He reproached
them for giving vent to their tongues and following evil leaders,
whose object it was to blacken his name, exaggerate his faults, and
hide his virtues. ‘Ye blame me,’ he said, ‘for things which ye bore
cheerfully from Omar. He trampled on you, beat you about with his
whip, and abused you. And yet ye took it all patiently from him, both
in what ye liked and what ye disliked. I have been gentle with you;
bended my back unto you; withheld my tongue from reviling, and my
hand from smiting. And now ye rise up against me!’ Then, after
dwelling on the prosperity of his reign at home and abroad, and the
many benefits that had accrued to them therefrom, he ended thus:
—‘Wherefore, refrain, I beseech you, from your abuse of me and of
my governors, lest ye kindle the flames of sedition and revolt
throughout the empire.’ The appeal (we are told) was marred by his
cousin Merwân, who at its close exclaimed, ‘If ye will oppose the
Caliph, we shall soon bring it to the issue of the sword.’ ‘Be silent!’
cried Othmân, ‘and leave me with my fellows alone. Did I not tell
thee not to speak?’ So Merwân remained silent, and Othmân
descended from the pulpit. The harangue had no effect for good.
The discontent spread, and the gatherings against the Caliph
multiplied.[471]
Thus ended the eleventh year of
Othmân’s reign. Near the close of it was Close of Othmân’s eleventh
year.
held a memorable council, of which we
shall read in the following chapter. The Caliph performed the
pilgrimage as usual. He had done so every year. But this was to be
his last.
 CHAPTER XXXIII.
THE OUTLOOK DARKENS.

A.H. XXXIV.—XXXV. A.D. 655.

The unhappy Caliph was now being

hurried on, by the rapid course of events, Contumelious treatment of
helplessly to his sad end. Abd al Rahmân, Othmân.
who, no doubt, felt a large measure of responsibility from the share
he took in the nomination of Othmân, was about this time removed
by death. But even he was dissatisfied; and one of the first open
denunciations of Othmân’s unscrupulous disregard of law—small it
might be, but significant—is attributed to him. A fine camel, having
come in with the tithes of a Bedouin tribe, was presented by the
Caliph, as a rarity, to one of his kinsfolk. Abd al Rahmân,
scandalised at the misappropriation of religious property devoted to
the poor, laid hands upon the animal, slaughtered it, and divided the
flesh among the people. The personal reverence attaching
heretofore to the ‘Successor of the Prophet of the Lord,’ gave place
to slight and disregard. Even in the streets, Othmân was greeted
with cries, demanding that he should depose Ibn Aámir and the
godless Abu Sarh, and put away from him Merwân, his chief adviser
and confidant. Nor had he any countenance or support whatever
from the people excepting his immediate kinsmen, and reliance upon
them only aggravated the clamour of the discontented.[472]
The conspirators canvassed in the
dark. They had been hitherto burrowing Othmân sends forth
carefully under ground. But now their messengers to inquire into
the feeling in the provinces.
machinations every here and there were
coming to the light, and rumours of treason began to float abroad.
The better affected classes in the great cities felt uneasy; alarm crept
over all hearts. Letters were continually received at Medîna, asking
what these ominous sounds of warning meant, and what catastrophe
was at hand. The chief men of Medîna kept coming to the Caliph’s
court for tidings; but, notwithstanding the sullen mutterings of nearing
tempest, the surface yet was still. At last, by their advice, Othmân
despatched four trusty persons one to each of the great centres,
Damascus, Kûfa, Bussorah, and Fostât, with a commission to watch
and report whether any suspicious symptoms were transpiring
anywhere.[473] Three returned saying that they discovered nothing
unusual in the aspect of affairs. The fourth, Ammâr, was looked for in
vain; he had, in fact, been tampered with and gained over by the
Egyptian faction. Thereupon Othmân despatched a royal edict to all
the provinces as follows:—At the coming pilgrimage the various
governors would, according to custom, present themselves at court;
whoever, then, had cause of complaint against them, or any other
ground of dissatisfaction, should come forward on that occasion and
substantiate the same, when wrong would be redressed; or else it
behoved them to withdraw the baseless calumnies which were
troubling men’s minds. Proclamation was made accordingly. The
plaintive appeal was understood; and the people in many places
when they heard it wept, and invoked mercy on their Caliph.
The governors repaired to Medîna at
the time appointed, but no malcontent Conference of Governors at
came forward to make complaint. Medîna. 655.
a.h. XXXIV. a.d.

Questioned by Othmân, his lieutenants

knew not of any grievance, real and substantial. To the outward eye,
everything was calm; and even the royal messengers sent to make
inquisition had returned without laying hand on anything amiss. But
all knew of the cancerous sore in the body politic, and of its
spreading rapidly. The wretched Caliph invoked their pity and their
counsel. But they could offer nothing of which he might lay hold. One
advised that the conspirators should be arrested and the ringleaders
put to death; another that the stipends should be forfeited of all
disloyal men; a third that the unquiet spirits amongst the people
should be diverted by some fresh campaign; others that the
governors should amend their ways. Othmân was bewildered; one
thing only he declared, that to measures of severity he never would
assent; the single remedy he could approve was the sending of fresh
expeditions to foreign parts.[474]
 Nothing was settled to avert the crisis,
and the governors departed as they came. Othmân declines help from
When Muâvia made ready to leave, he Muâvia.
once more warned Othmân of his danger, and entreated that he
would retire with him to Syria, where a loyal people were ready to
rally round him. But the Caliph answered: ‘Even to save my life I will
not quit the land wherein the Prophet sojourned, nor the city wherein
his sacred person resteth.’ ‘Then let me send an army to stand by
thee.’ ‘Nay, that I will not,’ responded Othmân firmly; ‘I never will put
force on those who dwell around the Prophet’s home, by quartering
bands of armed men upon them.’ ‘In that case,’ replied Muâvia, ‘I
see nought but destruction awaiting thee.’ ‘Then the Lord be my
defence,’ exclaimed the aged Caliph, ‘and that sufficeth for me.’[475]
‘Fare thee well!’ said Muâvia, and he departed, to see his face no
more.
As he took the road to Syria, Muâvia
passed by a group of the Coreish, amongst Muâvia retires, warning the
whom were Aly and Zobeir. He stayed for a Coreish.
moment to drop a warning word into their ears. They were drifting
back, he said, into the anarchy of ‘the days of Ignorance’ before
Islam. The Lord was a strong Avenger of the weak and injured ones.
‘To you’—and these were his last words—‘to you I commit this
helpless aged man. Help him, and it will be the better for you. Fare
ye well.’ And so saying he passed on his way. The company
remained some time in silence. At last Aly spoke: ‘It will be best done
as he hath said.’ ‘By the Lord!’ added Zobeir, ‘there never lay a
burden heavier on thy breast, nor yet on ours, than this burden of
Othmân’s to-day.’
 CHAPTER XXXIV.
THE PLOT RIPENS. CONSPIRATORS ATTACK MEDINA. DEATH
OF OTHMAN.

A.H. XXXV. A.D. 656.

The plot was now rapidly coming to a

head, and a plan of action had been Plot to surprise Medîna. End
already fixed. While the lieutenants of the of a.h. XXXIV. Summer of
a.d. 655.
Caliph were absent from their posts on the
occasion just described, the conspirators were to issue from Kûfa,
Bussorah, and Fostât, so as to converge upon Medîna in combined
and menacing force. There, in answer to the Caliph’s challenge, they
would present an endless roll of complaints, and cry loudly for
redress, reform, and the removal of their governors. If the request
were denied, they would demand the abdication of Othmân, and, in
the last resort, enforce their demand at the point of the sword. But as
to a successor they were not agreed. Kûfa was for Zobeir; Bussorah
was for Talha; Egypt’s favourite was Aly.
The scheme, being immature, at first
miscarried. But months later, in the middle The conspirators set out for
Medîna. Shawwâl, XXXV.
of the following year, it was revived and April, a.d. 656.
preparations made in secret for giving it
effect. Under the pretext of visiting Mecca, and there performing the
Lesser Pilgrimage, the concerted movement at last took place, two
or three months before the annual pilgrimage.[476] Abu Sarh, the
Governor of Egypt, on learning of the treasonable design, at once
despatched a messenger to apprise Othmân. In reply he was
ordered to pursue the rebels; he did so, but it was too late; they had
marched beyond his reach. On turning back, he found Egypt in the
hands of the traitor, son of Abu Hodzeifa,[477] and fleeing for his life,
took refuge across the border, in Palestine. Amongst the insurgent
leaders of Egypt was Mohammed, son of Abu Bekr.
 On receiving the intelligence that the
insurgents were marching on Medîna, The insurgents encamp near
Othmân ascended the pulpit of the Great Medîna; but retire.
Mosque and made known to the citizens the real object of attack. ‘It
is against myself,’ he said; ‘soon they will look back with a longing
eye to this my Caliphate, and wish that each day of the same had
been a year in length, because of the tumult and bloodshed, anarchy
and ungodliness, that will flood the land.’ The rebels were not long in
making their appearance, and they pitched three camps, the men of
Kûfa, Bussorah, and Egypt, each encamping separately, in the
neighbourhood of Medîna.[478] The citizens put on their armour, a
thing unheard of since the days of the Apostasy in the reign of Abu
Bekr, and prepared for resistance. The insurgents, foiled thus far,
sent deputies to the widows of Mahomet, and the chief men of the
city. ‘We come,’ they said, ‘to visit the Prophet’s home and resting-
place, and to ask that certain of the governors be deposed. Give us
leave to enter.’ But leave was not granted. Then the insurgent bands
despatched each a deputation to its respective candidate. Aly
stormed at the messengers sent to him as soon as they appeared,
and called them rebels accursed of the Prophet; and the others met
with no better reception at the hands of Talha and Zobeir. Unable to
gain over the citizens, without whose consent their object was out of
reach, the rebel leaders declared themselves satisfied with a
promise from the Caliph of reform, and, breaking up their camp,
retired in the order in which they came. They made as if each
company was taking its way home again, but really with the
concerted plan of returning shortly, when they expected to find the
city less prepared to resist.[479] The citizens cast aside their armour,
rejoicing in the apparent deliverance from a pressing danger; and for
some days things went on as before, Othmân leading the prayers.
Suddenly, the three bands reappeared at the city gates. A party
headed by Aly went forth to ask the reason. The strangers pointed to
a document attested by the Caliph’s seal;
this, they said, had been taken from a They return with document
servant of Othmân’s whom they caught bearing the Caliph’s seal.
hastening on the road to Egypt; and it contained orders that the
insurgents were to be seized and imprisoned, some tortured, and
some put to death. Aly, suspecting collusion, asked how the
discovery made by the Egyptian company on the road to Fostât had
become so promptly known to the others marching in quite a
different direction, to Kûfa and Bussorah, as to bring them all back
together? ‘Speak of it as ye will,’ they said, ‘here is the writing, and
here the Caliph’s seal.’ Aly repaired to Othmân, who denied all
knowledge of the document; but, with the view of clearing up the
matter, consented to receive a deputation of the rebel leaders.
Introduced by Aly, they made no obeisance to the Caliph, but with
defiant attitude approached and recounted their grievances. They
had retired with the promise of redress;
but, instead of redress, here was the Angry altercation with the
Caliph’s own servant whom they had Caliph.
caught posting onward to Egypt with the treacherous document now
produced. Othmân swore solemnly that he knew nothing of it. ‘Then
say who it was that wrote this order.’ ‘I know not,’ said the aged
Caliph. ‘But it was passed off as thine; thy servant carried it; see,
here is thy seal, and yet thou wast not privy to it!’ Again Othmân
affirmed that it was even so.[480] ‘Either thou speakest truth,’ they
cried in accents loud and rude, ‘or thou art a liar. Either way, thou art
unworthy of the Caliphate. We dare not leave the sceptre in the
hands of one who is either a knave or a fool too weak to govern
others. Resign, for the Lord hath deposed thee!’ Othmân made
answer:—‘The garment wherewith the Lord hath girded me I will in
no wise put off; but any evil ye complain of, that I am ready to put
away from me.’ It was all too late, they cried; he had often made, and
as often broken, the promise to amend; they could no longer put any
trust in him; now they would fight until he abdicated, or else was
slain. ‘Death,’ said Othmân, gathering himself up, with the firmness
and dignity which marked his last days—‘Death I prefer; as for
fighting, I have said it already, my people shall not fight; had that
been my desire, I had summoned legions to my side.’ The altercation
becoming loud and violent, Aly arose and departed to his home. The
conspirators also retired to their fellows; but they had now secured
what they wanted, a footing in the city. They joined in the ranks of
worshippers at the daily prayers in the Great Mosque, cast dust in
the face of Othmân as he officiated, and threatened the citizens to
make them keep away. The fatal crisis was hurrying on.
On the Friday following this scene,
when the prayers were done, Othmân Tumult in the Mosque;
ascended the pulpit. He first appealed to Othmân struck down.
the better sense of the citizens, who (he knew), however cowed by
the threats of the rebels, condemned their lawless attitude. Then
turning to the conspirators themselves, who had been taking part in
the service, he continued, ‘Ye are aware that the men of Medîna hold
you to be accursed at the mouth of the Prophet, for that ye have
risen up against his Caliph and Vicegerent. Wherefore wipe out now
your evil deeds by repentance, and by good deeds atone for the
same.’ One and another of the loyal citizens arose earnestly to
confirm the Caliph’s words and plead his cause; but they were
silenced and violently set down.[481] A tumult arose. The men of
Medîna were driven from the Mosque and its court, by showers of
stones. One of these struck Othmân, who fell from the pulpit to the
ground, and was carried to his house adjoining in a swoon. He soon
recovered, and for some days was still able to preside at the daily
prayers. But at last the insolence and violence of the insurgents,
rising beyond bounds, forced him to keep to his house, and a virtual
blockade ensued. But a body-guard of armed retainers, supported by
certain of the citizens, succeeded for the present in keeping the
entrance safe.
From the day of the first tumult, Aly,
Zobeir, and Talha (the three named by the Attitude of Aly, Zobeir, and
rebels as candidates for the Caliphate) Talha.
each sent a son to join the loyal and gallant band planted at the
palace door. But they did little more; and, in fact, throughout the
painful episode, they kept themselves altogether in the background.
After the uproar and Othmân’s swoon, they came along with others
to inquire how he fared. But no sooner did they enter, than Merwân
and other kinsmen tending the Caliph, cried out against Aly as the
prime author of the disaster, which would recoil, they said (and said
truly) upon his own head. Thereupon Aly arose in wrath, and, with
the rest, retired home. It was, in truth, a cruel and dastardly
desertion, and in the end bore bitter fruit for one and all. It was not
only a crime, but a fatal mistake. Alarm at the defiant rising against
constituted authority, and loyalty to the throne, equally demanded
bold and uncompromising measures. The truth was outspoken by
one of the Companions at the time. ‘Ye Coreish,’ he said, ‘there hath
been till now a strong and fenced door betwixt you and the Arabs;
wherefore do ye now break down the same?’[482]
So soon as the conspirators had shown
their true colours, Othmân despatched an Othmân closely besieged,
holds parley with Aly, Zobeir,
urgent summons to Syria and Bussorah for and Talha.
help. Muâvia, who had long foreseen the
dire necessity, was ready with a strong force which, as well as a
similar column sent by Ibn Aámir from Bussorah, hurried to their
master’s rescue. But the march was long, and the difficulty was for
Othmân to hold out until these columns reached. The insurgents had
entire possession of the Mosque and of the approaches to the
palace; and, in the height of insolence, their leader now took the
Caliph’s place at public prayers.[483] There were no troops at
Medîna, and Othmân was dependent on the little force that barely
sufficed to guard the palace entrance. It was composed of train-band
slaves, some eighteen near kinsmen, and other citizens including (as
we have said) the sons of Aly, Zobeir, and Talha. Apprehending, from
the ferocity with which the attack began now to be pressed, that the
end might not be far, Othmân sent to tell Aly, Zobeir, and Talha that
he wished to see them once more. They came and waited without
the palace, but within reach of hearing. The Caliph, from the flat roof
of his house, bade them to sit down; and so for the moment they all
sat down, both foes and friends, together. ‘My fellow citizens!’ cried
Othmân with a loud voice, ‘I have prayed to the Lord for you, that
when I am taken, he may set the Caliphate aright.’ After this, he
made mention of his previous life, and how the Lord had made
choice of him to be the Successor of his Prophet, and Commander
of the Faithful. ‘And now,’ said he, ‘ye have risen up to slay the
Lord’s elect. Have a care, ye men! (and here he addressed the
besiegers); the taking of life is lawful but for three things, Apostasy,
Murder, and Adultery. Taking my life without such cause, ye but
suspend the sword over your own necks. Sedition and bloodshed
shall not depart for ever from your midst.’ They gave him audience
thus far, and then cried out that there was yet a fourth just cause of
death, namely the quenching of truth by iniquity, and of right by
violence; and that for his ungodliness and tyranny he must abdicate
or be slain. For a moment Othmân was silent. Then calmly rising, he
bade the citizens go back to their homes; and himself, with but faint
hopes of relief, turned to re-enter his dreary abode.[484]
The blockade had now lasted several
weeks, when a mounted messenger The blockade pressed.
reached the city with tidings that succour Sufferings from thirst.
was on its way.[485] But this, coming to the knowledge of the Caliph’s
enemies, only made them redouble their efforts. They now closed
every approach, allowing neither outlet nor ingress to a single soul.
Water could be introduced by stealth only at night, and, there being
no well within the palace, the little garrison suffered the extremities of
thirst. On the appeal of Othmân, Aly interposed, and expostulated
with the besiegers. ‘They were treating their Caliph,’ he told them,
‘more cruelly than they would treat Greek or Persian captives in the
field. Even Infidels did not deny water to a thirsty enemy.’ But they
were deaf to his entreaty. Omm Habîba, the Prophet’s widow, and
sister of Muâvia, touched with pity, sought herself, with Aly’s aid, to
carry water upon her mule through the rebel lines into the palace; but
neither her sex nor rank, nor her relation to the Prophet, was
safeguard enough to prevent her being roughly handled. They cut
her bridle with their swords, so that she nearly fell to the ground, and
then drove her rudely back. The better part of the inhabitants were
shocked at the violence and inhumanity of the rebels; but none had
the courage to oppose them. Sick at heart, most kept to their
houses; while others, alarmed for themselves, as well as to avoid the
cruel spectacle, quitted Medîna. It is hard to believe that, even in the
defenceless state of the city, Aly, Zobeir, and Talha, the great heroes
of Islam, could not, had they really wished it, have raised an effective
opposition to the lawless work of these heartless regicides. History
cannot acquit them, if not of actual collusion with the insurgents, at
least of cold-blooded indifference to their Caliph’s fate.[486]
 The solemnities of the Káaba worship
were now at hand, and Othmân, still Annual pilgrimage to Mecca.
mindful of his obligation as head of Islam Dzul Hijj, a.h. XXXV. June,
a.d. 656.
to provide for their due observance, once
more ascended the palace roof. From thence he called the son of
Abbâs, one of the faithful party guarding the entrance, to come near,
and bade him assume the leadership of the band of pilgrims
proceeding from Medîna;—a duty which, much against his will, as
taking him away from the defence, he undertook at the Caliph’s
repeated command. Ayesha joined the party. She is accused of
having formerly stirred up the people against Othmân. Now, at any
rate, this impulsive lady not only shook herself free from the
insurgents, but, in order to detach her brother Mohammed, son of
Abu Bekr, also from their company, she besought him to accompany
her to Mecca. But he refused.[487]
The approach of relief at last goaded
the rebels to extremities, and they resolved The palace stormed. 18 Dzul
Hijj. June 17.
on a final and murderous attack. A violent
onset was made from all quarters, and the forlorn band of defenders
(including still the sons of Aly, Zobeir, and Talha), unable longer to
hold their ground, retired at Othmân’s command, but not without
difficulty, within the palace gate, which they closed and barred. In
doing this they covered their retreat with a discharge of archery, and
one of the rebels was killed thereby. Infuriated at their comrade’s
death, the insurgents rushed at the gate, battered it with stones, and
finding it too strong, sat down to burn it. Meanwhile others, swarming
in crowds from the roof of an adjoining building, gained an easier
access, and, rushing along the corridor, attacked the guard still
congregated within the palace gate. One was slain, Merwân was left
half dead, and the rest were overpowered.[488] Othmân had retired
by himself into an inner chamber of the women’s apartments; and,
seated there awaiting his fate, read from the Corân, spread open on
his knees. Three ruffians, sent to fulfil the bloody work, rushed in one
after another upon him thus engaged. Awed by his calm demeanour,
his pious words and mild appeal, each one returned as he went. ‘It
would be murder,’ they said, ‘to lay hands upon him thus.’
Mohammed, son of Abu Bekr, in his hate and rage, had no such
scruples. He ran in, seized him by the beard, and cried, ‘The Lord
abase thee, thou old dotard!’ ‘Let my beard go,’ said Othmân, calmly;
‘I am no dotard, but the aged Caliph, whom they call Othmân.’ Then,
in answer to a further torrent of abuse, the old man proceeded, ‘Son
of my brother! Thy father would not have served me so. The Lord
help me! To Him I flee for refuge from thee.’ The appeal touched
even the unworthy son of Abu Bekr, and he too retired. The
insurgent leaders, on this, crowded in
themselves, smote the Caliph with their And Othmân slain.
swords, and trampled on the Corân he had
been reading from. Severely wounded, he yet had strength enough
to stretch forth his aged arms, gather up the leaves, and press them
to his bosom, while the blood flowed forth upon the sacred text.[489]
Thus attacked, the faithful Nâila cast herself upon her wounded lord,
and, endeavouring to shield him, received a sword-cut which
severed some of the fingers from her hand, and they fell upon the
ground. The band of slaves attempted his defence. One of them
slew Sudân, the leader, but was immediately himself cut down and
killed. Further effort was in vain. They plunged their weapons into the
Caliph’s body, and he fell lifeless to the ground. The infuriated mob
now had their way. A scene of riot followed. They stabbed the
corpse, and leaped savagely upon it; and they were proceeding to
cut off the head, when the women screamed, beating their breasts
and faces, and the savage crew desisted. The palace was gutted;
and even Nâila, all wounded and bloody, was stripped of her veil.
Just then the cry was raised, ‘To the Treasury!’ and suddenly all
departed.[490]
As soon as they had left, the palace
gate was barred, and thus for three days Burial of Othmân.
the dead bodies of Othmân, Moghîra, and
the slave, lay in silence within. Then Zobeir ibn Motím, and Hakîm
ibn Hizâm (Khadîja’s nephew), chief men of the Coreish, obtained
leave of Aly to bury the Caliph’s body.[491] In the dusk of evening, the
funeral procession, including Zobeir, Hasan son of Aly, and the
kinsmen of Othmân, wended their way to the burying-ground of
Backî, outside the city. Death had not softened the rebels’ hearts,
and they pelted the bier with stones. Not in the graveyard itself, but
in a field adjoining, the body, with a hurried service, was committed
to the dust. In after years the field was added by Merwân to the main
burying-ground—a spot consecrated by the remains of the heroes of
Ohod, and many names famous in the early days of Islam; and there
the Beni Omeyya long buried their dead around the grave of their
murdered kinsman.[492]
Thus, at the age of eighty-two, died
Othmân, after a reign of twelve years. The His character.
misfortunes amongst which he sank bring
out so sharply the failings of his character that further delineation is
hardly needed. Narrow, weak, and vacillating, he had yet a kindly
nature which might have made him, in less troublous times, a
favourite of the people. Such, indeed, for a season he was at the
beginning of his Caliphate. But afterwards he fell on evil days. The
struggle between the Coreish and the rest of the Arabs was hurrying
on the nation to an internecine war. The only possible safety was for
the class still dominant to have opposed a strong and united front to
their adversaries. By his vacillation, selfishness, and nepotism,
Othmân broke up into embittered factions the aristocracy of Mecca,
and threw this last chance away.
 CHAPTER XXXV.
THE ELECTION OF ALY.

End of A.H. XXXV. June, A.D. 656.

On the Caliph’s death, his kinsfolk, and

such as had taken an active part in his Revulsion of feeling.
defence, retired from the scene. The city
was horror-struck. They had hardly anticipated, and could now with
difficulty realise, the tragical end. Many who had favoured, and some
who had even joined, the rebels, started back, now that the deed
was done. The nearer relatives of the murdered Caliph fled to Mecca
and elsewhere, with vows of vengeance. A citizen of Medîna,
wrapping carefully up the severed fingers of Nâila in the blood-
stained shirt of Othmân—meet symbols of revenge—carried them off
to Damascus and laid them at Muâvia’s feet.
For several days anarchy reigned at the
capital of Islam. There was neither Caliph Aly elected Caliph, 24 Dzul
nor any settled government. The regicides Hijj, 656.
a.h. XXXV. 23 June, a.d.

had the entire mastery of the city. Amongst

them the Egyptians were foremost in those first days of terror; and
public prayers (mark of supreme authority) were conducted in the
Great Mosque by their leader. Of the citizens, few ventured forth. At
last, on the fifth day, the rebels insisted that, before they quitted
Medîna, the citizens should exercise their right, elect a Caliph, and
restore the empire to its normal state. Shrinking, no doubt, from the
seething elements which Othmân’s successor would have at once to
face, Aly at first held back, and offered to swear allegiance to either
Talha or Zobeir. But in the end, pressed by the threats of the
regicides and the entreaties of his friends, he yielded, and so, six
days after the fatal tragedy, he publicly bound himself to rule
‘according to the Book of the Lord,’ and was saluted Caliph. Zobeir
and Talha were themselves the first to take the oath. They asserted
afterwards that they swore unwillingly, driven to do so through fear of
the conspirators. The traditions here are so divergent that it is hardly
possible to say how far this was true, or a mere afterthought.[493]
Talha’s arm had been disabled by the wound he received when
defending Mahomet on the battle-field; unhappy auguries were now
drawn from his withered hand being the first to strike the hand of Aly
in taking the oath of fealty. The mass of the people followed. There
were exceptions; for Aly was lenient, and, from a praise-worthy
delicacy, would not press the immediate adherents of the late Caliph
to swear allegiance.[494] The insurgents, having themselves done
homage to Aly, took their leave and departed to tell the tale at Kûfa,
Bussorah, and Fostât.
No bed of roses was strewn for Aly.
Both at home and abroad rough and He declines to punish the
regicides.
anxious work was before him. To the
standing contention between the Arabs and the Coreish was now
added the cry, which was soon to rend Islam, of vengeance on the
regicides. Further, the red-handed treason enacted at Medîna had
loosened the bonds of society. Constituted authority was set at
naught. Bands of Bedouins, scenting from afar the approach of
anarchy and the chance of plunder, hung about the city. They were
bidden to depart; but encouraged by the servile population, which,
broken loose during the insurrection, still kept aloof from their
masters, they refused.[495] Aly was pressed on many sides, by those
who held him bound by his accession-oath, to vindicate the majesty
of the Divine law, and to punish the wicked men who had imbrued
their hands in the blood of Othmân. Even Talha and Zobeir,
awakening too late to the portentous nature of the crime enacted
before their eyes and hardly against their will, urged this. ‘My
brothers,’ replied Aly, ‘I am not indifferent to what ye say. But I am
helpless. These wild Bedouins and rampant slaves will have their
way. What is this but an outburst of Paganism long suppressed—a
return, for the moment, of “the days of Ignorance,” a work of Satan?
Just now they are beyond my power. Let us wait; and the Lord will
guide us.’ This waiting, hesitating mood was the bane of Aly’s life.
He loved ease; and though sometimes obstinate and self-willed, his
ordinary principle was that things left to themselves would mend.
 The Coreish were anxious and
alarmed. The revolt, under the veil of The Coreish alarmed.
discontent at the ungodly rule of Othmân,
was now (they said) taking a far wider range. The Bedouins were
becoming impatient of the control of the Coreishite aristocracy; and
that which had happened to the Beni Omeyya—now forced to fly
Medîna—might happen at any moment to the whole body of the
Coreish. Yet Aly, though professing to denounce the attack of the
regicides as high treason, took no steps to punish it, but temporised.
A prompt and vigorous pursuit of the traitors would no doubt have
been joined in, heart and soul, by Muâvia and by the whole nobility
of Islam. But Aly preferred to let the vessel drift, and so it was drawn
rapidly into the vortex of rebellion.
The next matter which pressed for
immediate settlement was the Aly seeks to supersede
confirmation, or otherwise the Muâvia in Syria.
supersession, of the various governors of provinces and cities; and
here Aly, turning a deaf ear to his friends, proved himself wayward
and precipitate. When Ibn Abbâs returned from the pilgrimage at
Mecca (to the presidency at which he had been deputed by the late
Caliph), he found that Moghîra had been wisely urging Aly to retain
the governors generally in their posts, till, at the least, the people
throughout the empire had recognised his succession to the throne.
But Aly had flatly refused.[496] Ibn Abbâs now pressed the same
view: ‘At any rate,’ he said, ‘retain Muâvia; there is a special reason
for it; Omar, and not Othmân, placed him there; and all Syria
followeth after him.’ The advice, coming from so near and
distinguished a kinsman of his own, deserved the consideration of
Aly. But he answered sharply, ‘Nay; I shall not confirm him even for a
single day.’ ‘If thou depose him,’ reasoned his friend, ‘the Syrians will
question thine election: and, worse, they may accuse thee of the
blood of Othmân, and, as one man, rise up against thee. Confirm
him in his government, and they care not who is Caliph. When thou
art firmly seated, depose him if thou wilt. It will be easy with thee
then.’ ‘Never,’ answered Aly, ‘he shall have nought but the sword
from me.’ ‘Thou art brave,’ Ibn Abbâs replied, ‘but innocent of the