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ISLAMIC MEDICAL EDUCATION RESOURCES 04

24.1 PATHO-PHYSIOLOGICAL DISTURBANCES

By Professor Omar Hasan Kasule Sr.

24.1.1 GENERAL ILL FEELING AND GENERAL WEAKNESS

Non-obligatory duties are delayed but obligatory acts like salat, saum, and hajj are delayed only for physical inability to perform. The physically disabled is allowed to pray sitting or lying down. Exemption from saum is only for potential physiological harm. The weak can leave Muzdalifah earlier. Travelers may shorten and/or combine salat or break the fast and make up later. Salat, saum, and hajj rites are delayed for high fever. Non-obligatory fasting is recommended for the obese but is discouraged for the under-weight and the pregnant. Obligatory fasting and jihad are delayed in cases of extreme malnutrition and cachexia. The obese are obliged to reduce weight especially if they have impairments in salat, sexual function, and jihad. The underweight are obliged to seek nutritional treatment. Extreme fatigue necessitates delay of salat for lack of concentration, delay of saum, delay of hajj rites except standing at Arafat. Acts of ‘ibadat cannot be delayed in the chronic fatigue syndrome. The victim of this condition should try to perform as many acts as are possible and in the meanwhile try to seek treatment. Supplications, dua, and recitation of the Qur’an are highly recommended because diseases of the heart may be an underlying cause of the chronic fatigue syndrome.

 

24.1.2 FEVER

High fever may be reason for delaying salat because of generalized weakness and discomfort. Saum with high fever aggravates dehydration and may have to be delayed. In cases of high fever, hajj may be difficult due to general weakness and lack of physical energy to complete the rites of pilgrimage. Fever aggravates dehydration in the dry climate of Hejaz. Care must be taken to prevent spread of contagious diseases because most cases of fever are due to infection.

 

24.1.3 PAIN

Salat is delayed for severe acute headache, acute backache, and skin itch until the patient is able to concentrate. Salat is not delayed for chronic backache or skin itch but should be made as short as possible. Salat is interrupted for an anginal attack to rest and use medication and is continued after that with sujuud al sahaw at the end. Use of sub-lingual medication does not nullify the salat of a patient with chronic angina. Arthritic joint pain necessitates restricting movements during salat. If the pain is severe, the guidelines for the salat of the sick are followed. Patients with chronic pain on regular twice or thrice daily medication are exempted from fasting. Joint or back pain in hajj is an exemption to allow the pilgrim to be carried or to be put on wheeled transport during tawaaf and sa ay.

 

24.1.4 ALTITUDE AND SPACE

Concentration is salat at high altitude is impaired of low oxygen concentration. Salat in weightless space is feasible but the physical movements may be restricted and the guidelines of the salat of the sick may have to be employed. Saum at high altitudes is a challenge because of the cold that requires high and regular food intake to generate enough metabolic heat to keep the body warm in the cold atmosphere. The impact of weightless ness in space on saum has not yet been studied.

 

24.1.5 ADVERSE ENVIRONMENT

Salat is delayed on a hot day until the temperature cools down to what is reasonable. Tayammum is carried out on cold days even if water is available. Cooling the body is permitted in saum. Saum can be broken on very hot days for fear of severe dehydration. Special protection is needed against heat stroke and dehydration during hajj. Tayammum is prescribed if the extreme cold may aggravate peripheral vascular disease. If the floor is too cold to stand during prayer, wearing of sandals or khuff is allowed. If frostbite or hypothermia occurs as a result of cold exposure, fasting is broken to eat food to generate enough metabolic heat to raise body temperature. Saum may be broken on cold days for fear of severe dehydration and due to increased calorie requirements to maintain body temperature. Salat on a cold day is preferably offered in the home to avoid cold exposure in the atmosphere. In case of fear of light injury it is recommended to pray inside a house, use a shelter, or wear special headgear and eye wear to avoid cosmic radiation. Photo dermatitis in hajj is avoided by avoiding going out during the middle of the day.

(c) Professor Omar Hasan Kasule Sr. 2004