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ISLAMIC MEDICAL EDUCATION RESOURCES 04

0010-ISLAMIZATION OF MEDICAL SCIENCES (PART II)

Lecture for 1st year medical students on 20th October 2000

2.0PROPHETIC MEDICINE

A. BASIC CAHARACTERISTICS OF PROPHETIC MEDICINE

DEFINITION

Tibb Nabawi refers to words and actions of the Prophet with a bearing on disease, treatment of disease, and care of patients.  Thus also included are words of the prophet on medical matters, medical treatment practiced by others on the prophet, medical treatments practised by the prophet on himself and others, medical treatments observed by the prophet with no objections, medical procedures that the prophet heard or knew about and did not prohibit, or medical practices that were so common that the prophet could not have failed to know about them.  The prophet's medical teachings were specific for place, population, and time. They however also included general guidance on physical and mental health that are applicable to all places, all times, and all circumstances. Tibb nabawi is not one monolithic or systematic medical system as some people would want us to believe. It is varied and circumstantial. It covers preventive medicine, curative medicine, mental well-being, spiritual cures or ruqyah, medical and surgical treatments. It integrates mind & body, matter and spirit.

 

SEARCH FOR CURES

The Prophet enunciated a basic principle in medicine that for every disease there is cure (ma anzala allahu daa; illa anzala lahu shifa'a- Kitaab al Tibb, al Bukhari).  This is an impetus for us to look for remedies. Thus the prophetic medical tradition does not stop at only the medical teachings of the prophet but goes beyond to encourage humans to search and experiment with new treatment modalities. This implies among other things that prophetic medicine is not static. There is room for growth and even breaking new ground. Al Habba al Saudaa was recommended by the the Prophet as a general treatment and has been studied extensively (Najjar 1992).  Dr. el Kadhi has conducted scientific studies (on its immune effects) that have been published in leading scientific journals in the USA. Other implications of this hadith is that seeking treatment does not contradict qadar (pre-destination). Thus both the disease and its treatment are part of qadar.

 

B. SOURCES OF TIBB NABAWI

PRE-ISLAMIC ARAB MEDICINE

Tibb nabawi has several sources: revelation (wahy), empirical experience of the prophet, folk medicine of that time in the Arabian peninsular, and it is possible that some medical knowledge of other communities could have been known in Makka or Madina at the time of the prophet.

 

THE QUR’AN: A SOURCE OF TIBB NABAWI

Tibb Qur’ani refers to verses of the Qur’an that relate to diseases of the body and the mind and their treatment.  The Qur’an talks about physical ill health (2:196, 24:61, 48:17, 2:184/5, 1:196, 4:43) and mental ill-health/diseases of the heart (10:57, 2:10, 74:31, 24:48, 2:48, 74:31, 24:50, 22:53, 33:32, 17:52).  Ultimate cure of diseases is from Allah (26:80).  The Qur’an itself is a cure (17:82).  It contains supplications for good health as well as guidance on specific therapy such as honey (16:69), eating only hood halal food avoiding unhealthy haram food (2:168, 2:172-173, 6:118-119, 6:121, 6:145-146, 16:114-118, 5:2, 5:4-6)  and not in excessive amounts (5:90). The Qur’an has many medical teachings and have been referred to by some authors as Islamic medicine (Abdullah no date, Ta-ha, Bar-no date). Many authors, some non-physicians, have written about Tibb Qur’ani (Abdullah-no date, Bar 1981, 1985).  Attempts have been made to provide scientific explanations for Qu’ranic verses related to medicine covering contagion, adwah, alcohol, creation, and medical benefits of fasting.  Attempts have been made to establish medicinal value of plants, like zaitoon, tiin, dates, milk, and fruits, mentioned in the Qur’an as food but not as cures. In general these writings have lacked scientific rigor or accuracy and have created more confusion than clarity.  This approach can also mislead some people into thinking that they know the full reasons behind a certain Qur’anic injunction.  Unless clearly stated in the Qur’an itself or by authentic Sunnah, the reasons behind Qur’anic injunctions are unknowable to us with certainty.  All we can do is research and make Ijtihad, we could be right or wrong. We must have the humility to realize that we may not reach the whole truth and the scientific explanations that we propose may be wrong or may be only part of the explanation. The Qur’an is not a textbook of medicine but a book of moral guidance. It contains basic information and guidance on medical matters leaving the room open for humans to undertake research and fill in the details. Confining medicine to only the teachings in the Qur’an would make it very limited because the Qur’an is very selective in coverage of details  leaving the field open to humans to observe, search for an understand Allah’s signs on earth. Such constraints on the concept of Islamic Medicine would also discourage further research and scientific exploration.

 

HADITH AS A SOURCE OF TIBB NABAWI

The following were the forms of prophet’s medical teachings: words of the prophet on medical matters, medical treatment practiced by others on the prophet, medical treatments observed the prophet with no objections, medical procedures that the prophet heard/knew about and did not prohibit. The total number of hadiths on medicine is about 300; many do not reach the degree of hasan. Bukhari in his Sahih narrated 129 hadiths directly related to medicine. He devoted two books to medicine: kitaab al tibb and kitaab al mardha There are many other hadiths in Bukhari indirectly related to medicine. Other books of hadith also narrate more hadiths with relevance to medicine. Scholars have collected these hadiths together and some have related them to available medical knowledge. Among these authors are: Abu Nu’aim Ahmad bin Abdillah al Asfahani (d. 430 AH),  Abu al Abbaas Ja’afar bin Muhammad al Mustansiri (d. 432 H), Shams al Ddiin Muhammad Ibn Ahmad al Dhahabi (d. 748 H), Ibn  Qayyim al Jawziyat (d. 751 AH / 1350 CE), Jalaluddin Abd al Rahman al Suyuti  (d. 911 AH), and Abu al Hasan Nur al ddiin Ali Bin Muhammad al jazaar al Masri (d. 914 H). In his book, A Tibb al Nabawi, Imaam Ibn al Qayim al Jawziyat mentions many medical conditions for which the Prophet provided guidance.  He interpreted the hadiths using the available medical knowledge of his day. This book needs rewriting and it will look very different if written interpreting the prophetic traditions using today's medical knowledge.

 

C. CLASSIFICATION OF TIBB NABAWI:

PREVENTIVE TIBB NABAWI

The classification of traditions relating to medicine depends on the state of knowledge and changes with time and place. Jalaluddin al Suyuti published a book on tibb nabawi and divided medicine into 3 types: traditional, spiritual and preventive. Most of tibb nabawi is preventive medicine which is a very advanced concept given the level of scientific knowledge at the prophet's time and certainly must have been divinely inspired. Al Suyuti (1994) listed preventive medical measures such as food and exercise. Other preventive measures taught in hadith include: quarantine for epidemics, hijr sihhi, forbidding urination in stagnant water, bawl fi mai raqid, use of tooth stick, siwaak, precautions in the house at night: fire & pests, leaving a country because of its water and climate.

 

SPIRITUAL TIBB NABAWI

Study of tibb nabawi reveals that there are spiritual aspects of healing and recovery. Prayer, dua, recitation of the Qur’an, and remembrance of Allah play a central role. Psychosomatic diseases could respond to spiritual approaches. The use of ruqyat (surat al fatiha, al mu’awadhatain) falls between physical curative and spiritual. The curative part of ruqyat can be understood in modern terms in the way the psyche can modulate immune mechanisms that protect against disease.

 

CURATIVE TIBB NABAWI

Ibn Qayim al Jawziyat listed many diseases with their recommended treatments from tibb nabawi. Diseases in tibb nabawi treatable by natural remedies: fever, humma;  bowel movements, istitlaq al batan; dropsy, istisqa; wounds, jarh; epilepsy, sar’a; sciatica, ‘irq al nisa; temperaments, tabau’; skin itch, hakk al jism; pleurisy, dhaat al janb;  headache and hemicrania, sidau and shaqiiqat; inflammation of the throat, ‘adhrat;  enlargement of the heart, al maf’uud; ophthalmia, al ramad; catalepsy, khudran al kulli; pimples, bathrat; skin eruptions, awraam;  food poisoning, sum;  witchcraft, sihr; and head lice. He also mentioned other diseases like: plague, leprosy, eye diseases, throat and tonsils, diarrhea, abdominal disease, fever, plague, snake bite, scorpion bite, food contamination by a fly, headache, nose bleeds, teeth, cough, dropsy, sprain, fracture, bite by rabid dog, and the evil eye. The medical treatments mentioned were honey, al 'asal; cold water for fever, al mau al barid; diet, ghadha; milk, al laban; camel milk; camel urine. The black seed, al habba al sauda, was especially emphasised. The surgical treatments mentioned were: cupping, al hijaam; cauterization, al kayy; venesection with cauterization, qatiu al uruuq wa al kayy.

 

D. APPLICATION OT TIBB NABAWI TODAY

GENERAL CONSIDERATIONS

There are 3 aspects that we have to deal with regarding modern application of tibb nabawi. (a) is tibb nabawi part of the sharia? (b) what is the scope of tibb nabawi? (b) spatio-temporal changes (c) empirical research on tibb nabawi.

 

TIBB NABAWI AS PART OF THE SHARIAT:

A correct answer to this question requires clarifying the very concept of shariat. The regulations about salat, menstruation, and toilet hygiene are part of the shariat rules that are immutable and there is no dispute about them. There are other regulations about the government, ahkam sultaniyat,  that are part of the shariat but that change with circumstances. We can therefore distinguish two parts of the shariat: (a) fixed and immutable and applicable to all places and times and (b) fixed general principles whose details of application change with place and time. If we take the meaning of shariat in (b) above we can conclude that prophetic medicine is part of Islamic shariat that can change and grow using ijtihad and empirical research to apply general shariat principles to changing circumstances.

 

SCOPE OF TIBB NABAWI

Tibb Nabawi as reported to us did not cover every conceivable disease at the time of the Prophet neither can it cover all ailments today or in the future in various parts of the world.  This is easy to understand from the context that although the Prophet practiced medicine, his mission was not medicine and he was not a full-time physician.  The hadiths of the Prophet should not be looked at as a textbook of medicine.  They should be used for the diseases that they dealt with.  The proper way to get additional medical knowledge is through research and looking for signs of Allah in the universe (2:164, 3:190, 10:5-6, 30:20-27, 39:59, 51:20-23).

 

SPATIO-TEMPORAL CHANGES

Whatever the Prophet said or did was valid and must be followed because he never uttered any untruth even when joking. The ijtihad of the prophet even in worldly matters was protected, ma'suum. The Qur'an and hadith have records of divine intervention to comment on the prophet's ijtihad on worldy matters such his advice on some aspects of agriculture that he later withdrew. Thus the record of authentic hadith that we have is valid whether in 'aqidat or worldly matters.  The attempt to distinguish between the medical teachings of the prophet-messenger and as a human living in Arabia at a particular historical epoch is not easy and is of no practical significance.  The question is whether all or some of the tibb nabawi should be used today.  If the diagnosis of a disease and all the circumstances surrounding it are exactly like those at the time of the Prophet, then we have no hesitation in saying tibb nabawi should be used. In actual practice it is difficult to ascertain that the conditions are the same.  Changes in disease pathology, changes in the  genetic pool of the patients, changes in the genetic pool of the medicinal plants, weather and climatic conditions are among many variables that may make a particular remedy recommended by the Prophet not appropriate for a medical condition today. The circumstances of time and place have changed. Indiscriminate use of the historical remedies could be using the right drug for the wrong disease. There is even a more serious linguistic problem. The meaning of words has changed. What was called fever in the 1st century AH may not be the same as the meaning of the same world today. Even medicinal plants like the black seed may not be exactly the same plant. We can therefore conclude that the teachings of tibb nabawi can only be a foundation to guide and encourage scientific research for remedies that are suitable for our times.

 

EMPIRICAL RESEARCH ON TIBB NABAWI:

 There is a lot of scientific interest in prophetic teachings on medicine. In Egypt for example many institutions are involved in research on traditional remedies: universities, the National Research Center, the Desert Institute, and the Horticultural Department of the Ministry of Agriculture. Many medicinal plants including the black seed have been investigated extensively and have been commercialised (Sayed 1980). The black seed (nigella sativa) is an example of a prophetic remedy that has been studied extensively by both Muslims and non-Muslims. Animal research has shown that the black seed is a potent anti-hypertensive (Tahir et al. 1993) and respiratory stimulant (Tahir at al 1993). It was shown to act against bacterial infection in mice (Hanafy  et al. 1991). Al-Awadi et al (1991) studied the effect of a plant mixture including black seed on liver gluconeogenesis in rats with induced diabetes. Salomi et al (1991) studied the inhibitory effects of the black seed on chemical carcinogenesis in rats. Nair et al (1991) studied the modulatory effect of the black seed on toxicity in rats induced by a cis-platinum, a cancer treatment drug. Keshri et al (1995) studied the post-coital contraceptive effects of the black seed in rats. El-Dakhakhny (1965) studied the pharmacological properties of the black seed. Toppozada et al (1965) studied the antibacterial properties of the black seed with clinical applications. El-Fattary (1975) isolated and described the anti-bacterial principles from the black seed. Chakravarty (1993) studied the inhibition of histamine release from mast cells by the black seed. Salomi et al (1992) studied the anti-tumor activity of the black seed. Human studies of the black seed have also been undertaken. Akhtar et al (1991) studied the effect of the black seed on nematode worm infection in children. Haq et al (1995) studied the effect of the black seed on human lymphocytes and polymorphonuclear leucocyte phagocytic activity. Laboratory studies provided scientific support for the traditional use of the black seed and its derived products As a treatment for rheumatism and related inflammatory diseases (Houghton et al 1995). The study of the black seed as a medicine has even extended to its side effects since no medicine however useful is free from side effects. Steinmann et al (1997) recorded occurrence of contact dermatitis after topical use of the black seed. Tennekoon et al. (1991) studied the possible hepato-toxicity of the black seed.

 

E. CONCLUSION AND FUTURE CHALLENGES

From the survey above we can conclude that tibb nabawi is an authentic and valid medical system. The general principles of this system are applicable at all times and all places. The specific remedies taught by the Prophet (PBUH) are valid and useful. They however can not be used today without undertaking further empirical research

 

3.0 ISLAMIC MEDICINE, mafhum al tibb al islami

A. CONFUSION BETWEEN MUSLIM AND ISLAMIC

The concept of Islamic medicine has been understood to mean different things by different people at different times.  There has been a proliferation of writings on Medicine from an Islamic perspective by both physicians and non-physicians (Ullman 1978, Athar 1993, Said 1976, El Kadhi 1980, Madkhur 1987, Akkibi 1957, Nadvi 1983, Rahman, Kasule 1980 1981) as well as a general interest in health-related issues such as diet, lifestyle (Sakr, Ali et al. 1987).  Scientific research has been undertaken by Dr El Kadhi in Florida, USA.  Starting in the early 1980s international conferences and conventions on Islam and Medicine have been held in several countries (IOIM 1980, 1981). The greatest confusion has been semantic with many dire practical manifestations.  ‘Islamic’ and ‘Muslim’ Medicine have been confused. The terms ‘Islamic’ and ‘Muslim’ are used interchangeably as if they mean the same (Said 1976, Ibn al Qayyim 1993). Traditional medicine practised by Muslim communities at some epochs in history or in our times has erroneously been called Islamic medicine. The semantic confusion between the adjectives ‘Islamic’ and ‘Muslim’ need not continue.  ‘Islamic’ refers to values, ideals, guiding principles, and application of the Qur’an and Sunnah. ‘ Muslim’ refers to people who self-identify as Muslims as well as their activities and institutions.  They may not fully follow all the teachings of Islam.  Thus Islamic Medicine the ideal, is not the same as Muslim medicine, which is the actual historical or contemporary reality of Muslim societies (Kasule 1980). Islam is objective and universal.  Islamic Medicine would therefore be the true and objective medicine that all people would accept irrespective of their geographical location, cultural or religious background. The continuing confusion in the minds of many Muslim physicians about what constitutes Islamic Medicine calls for this fresh attempt at definition and conceptualization of Islamic Medicine.

 

B. CRITIQUE OF VARIOUS DEFINITIONS OF ISLAMIC MEDICINE

OBJECTIVE CRITERIA

Ahmad El Kadhi presented a paper at the First International Conference on Islamic Medicine held in Kuwait in January 1980 (Athar 1993) and proposed 6 distinguishing criteria of Islamic medicine and using statistics and medical experience in the US argued that modern western medicine did not fulfill the criteria of being (a) excellent and advanced; (b) based on faith and divine ethics; (c) guided and oriented, ie consistent and logical; (d) comprehensive, paying attention tot he body and the spirit, the individual and the society; (e) universal, utilizing all useful resources and offers its services to all mankind; (f) scientific. Two of the 6 criteria require a re-examination.  Criterion (a) should not be taken in an absolute way.  A medical system’s excellence or advancement is a relative assessment based on the knowledge and resources available at a particular time and a particular place. Medical systems are continuously improving making it virtually impossible to classify them at a particular point in time as excellent.  Criterion (e) about medicine being scientific could better be defined as based on objective research using all sources of knowledge available including revelation.  The word ‘scientific’ and ‘scientific method’ have been misused as representing objectivity when in practice we know that there are many in-built biases in today’s medical research that reflect subjective opinions, philosophies, and world views.  This is in addition to fraud and incompetence that are reported in the press.

 

VALUES AND ETHICS

Use of values and ethics as defining characteristics was seen as an improvement on the definition of Islamic Medicine using operational criteria. The criteria are difficult to measure and compare across different systems of medicine. Dr. Omar Hasan Kasule, Sr. in a paper presented to the first International Islamic Medicine Conference Kuwait (Kasule 1980) argued that Islamic medicine can be defined only as values and ethics and not as any specific medical procedures or therapeutic agents.  This definition allows Islamic medicine to be a universal all-embracing concept that has no specific or particular time-space characteristics. A definition based only on values is however too general to be useful operationally.  Values can be very subjective and difficult to define exactly.

 

ETHICAL PHYSICIANS

There is an argument that you can get to Islamic medicine by ‘Islamizing” the physician especially during training.  Then you are sure that his research, work and practice will be in conformity with the teachings of Islam. Naqib (1984) proposed a complete Islamically-based education system for an aspiring physican starting from elementary to post graduate levels including describing attributes of a physician, his rights and obligations. Deep study of medicine with reflection shows the physician the majesty of the creator and this deepens and strengthens iman  (Jalabi 1974, Jalabi 1978, Kasule 1980).  A believing physician will be more ethical in his research and practice. Ethics involves: making sure the physician has the appropriate level of knowledge and skill, charging reasonable fees for services, etiquette with patients especially of the opposite gender, treating patients after their consent. There have been several attempts to define medical ethics for a Muslim physician, ancient and modern.  Al Tabari described the Islamic code of medical ethics in 970 AD to include the following:  personal characteristics of the physician, obligations towards patients, obligations towards the community, obligations towards colleagues, and obligations to his assistants.  The Islamic Medical Association of the US and Canada adopted the Oath of a Muslim Physician in 1977 as an alternative to the Hippocratic oath.  The Islamic Code of Medical Ethics issued by the International Organization of Islamic Medicine Kuwait 1981. Amine and El Kadhi (Athar, 1993) based medical ethics on the Qur’an “the physician must believe in God, and in the Islamic teachings and practice it in private and public life; be grateful to his parents, teachers, and elders; be humble, modest, kind, merciful, patient, and tolerant; follow the path of the righteous;  and always seek God’s support.  The Muslim physician must stay abreast of current medical knowledge, continuously improve his skills, seek help whenever needed, and comply with legal requirements governing his profession; realize that God is the maker and owner of his patient’s body and mind and treat him within the framework of God’s teachings; realize that life was given to man by God, that human life starts at the time of conception, and that human life cannot be taken away except by God or with His permission; realize that God is watching and monitoring every thought and deed; follow God’s guidelines as his only criteria, even if they differ with popular demand or the patient’s wishes; not recommend nor administer any harmful material; render needed help regardless of financial ability or ethnic origin of the patient; offer needed advice with consideration for both the patient’s body and mind; protect the patient’s confidentiality; adopt an appropriate manner of communication; examine a patient of the opposite sex in the presence ot a third person whenever feasible; not criticize another physician in the presence of patients or health personnel, refuse payment for treatment of another physician or his immediate family; and strive to use wisdom in all his decisions”.

 

Ethics alone cannot change a medical system.  The saying of Othman bin Affan is very relevant here ‘Allah can remove things through the ruler what is not removed by the Qur’an”.  Moral values alone may not be enough to change the reality.  The physician may be good and ethical but if the system he is working is in unethical, he will be ineffective.  We therefore cannot define a medical system by its ethics alone. It is not enough to say that Islamic medicine is what good Muslim physicians practise.

 

C. CRITIQUE OF VARIOUS MANIFESTATIONS OF ISLAMIC MEDICINE

EARLY MUSLIM MEDICINE

Much has been written about Muslim contributions to medicine (Shahine 1971, Graziani 1980, Hunain 1985, Ullman 1978, Andalusi 1985, Dib 1979, Nadvi 1983, Najjar 1986, Said 1976).  Some is with justifiable pride.  Some is exaggerated and manifests a certain amount of an inferiority complex vis a vis the west.  We are trying to tell the west that even though our situation today is bad we were great in history and we taught them medicine.  Some claims are valid and provable whereas others cannot be sustained.  Ibn Sina was undoubtedly a great physician whose influence spanned many centuries.  The Claim that Al Zahrawi was the first surgeon in the world (Dib 1989) is preposterous.

 

Old Muslim medicine passed through 3 stages. The first stage, the school of commentators on Greek works (madrasat shurrah al ighriqiyin) lasted from the 7th to the 9th century AD.  It was a period of translation of foreign sources (Greek, Syriac, Hindi, Persian) into Arabic.  some of the existing Arab folk medicine was also incorporated (Hamaidan-no date).  The second stage, 9th - 13th centuries AD, was a period of original research to add to and enrich the translated material.  Hospitals and medical schools were established, medical procedures were refined, and physicians were licensed to make sure they had sufficient skills and knowledge.  Dr Jalal Musa (1972) described the research methodology of what he called Arab medicine as empirical observation.  He based these conclusions on a detailed study of 2 representative physicians: Ibn Sina and Al Razi.  The third stage, after the 13th century, witnessed the decline of science and knowledge in general.  Some Muslim scholars preserved the knowledge they had and passed it on to Europe. 

 

Several factors contributed to the growth of Muslim Medicine.  The most important impetus and momentum for inquiry and scientific exploration from the golden era of the Prophet and the Khulafa al Rashidiin. Pax Islamica  over a wide multinational empire with relative stability and rulers who patronized learning assisted the growth of medical knowledge.  However the environment in which that knowledge grew was already in decline especially in the political and moral spheres and it was only a matter of time before the medicine itself decline.  Decline in Muslim science and medicine accompanied the political problems that led to political weakness and the decline was essentially completed by 1350 AD. 

 

From very early times (as early as 3rd century AH),  biographies of Muslim physicians were compiled and we know a lot about their activities and achievements (Hunain and Andalusi 1985).  The early physicians were encyclopedic in knowledge being competent in many different disciplines.  Some of them were not Muslims; others were recent converts to Islam.  Many were influenced by Greek philosophy then very current.  Ibn Sina was referred to as “al muallim al thalith” the third teacher-philosopher after Aristotle and al Farabi.  Al Razi was called the physician-philosopher while Ibn Sina was called the philosopher-physician (Najar 1986).  Some were very pious Muslims whereas others, being humans, had their personal weaknesses.  Some of the physicians were close to and served the rulers of the time who led regimes that were not fully Islamic.  It is therefore incorrect to generalize and treat every physician at that time as a model for Islamic Medicine. 

 

Can the medicine practiced in the early Islamic state be called Islamic medicine?  This medicine developed mainly because of the political conditions of a large and relatively stable empire whose rulers encouraged learning.  The rulers and governments of that time can hardly be described as fully islamic.  The golden era of medicine (Abassid era) came a long time after the golden era of Islam, khilafat rashidah. Medical knowledge was translated from other societies and Muslims added to it.  Islamic principles had an impact on the developing medical knowledge but cannot be said to have been the sole guiding spirit.  It is noteworthy that the dean of early Muslim medicine, Al Shaikh al Rais Ibn Sina, did not include an Islamic philosophic or ethical dimension when he defined medicine as ‘knowledge of the states of the human body in health and decline in disease: its purpose is to preserve health and restore it whenever it is lost” (Said 1977). We therefore conclude that this was Muslim medicine and not Islamic Medicine.  The ancestors achieved a lot in their time.  The challenge is for us to achieve in our times.  They had their achievements and we must have our achievements (2:139, 2:141)

 

CONTEMPORARY MUSLIM TRADITIONAL MEDICINE

Traditional Muslim medicine, a remnants of the medicine practiced in the early Muslim state, has been looked at as Islamic Medicine.  It has changed considerably from what it was in the 3rd century AH. It has incorporated new treatment modalities and varies from country to country. Folk medicine of any Muslim people could also fit into this category of Muslim traditional medicine. Traditional medicine is practiced as folk medicine or as recognized and officially sanctioned alternative medicine such as the Unani (Arab) medicine in the Indo-Pakistani Peninsular.  The Indian government recognizes 4 traditional medical systems: one of them is unani (Arab) the othes are: ayurveda, siddha,and yoga. The current effort to revive ‘traditional’ Muslim medicine is part of a movement world wide that seeks to revive old remedies.  There are several reasons for this: failure of modern western medicine to reach a big proportion of people especially in rural areas, the realization that there are good things in the traditional systems, increasing assertiveness of third world countries vis a vis Europe and America, and cultural nationalism.  Traditional medicine systems have the advantage of being more human, little dehumanizing technology, and interest in the individual. The World Health Organization passed a resolution in May 1977 that argued ‘interested governments to give adequate importance to the utilization of their traditional systems of medicine with appropriate regulations as suited to their national health systems”. The State of Kuwait is an example of the new interest in Unani medicine.  It invited 2 Indian experts in Unani medicine to visit Kuwait and explore the possibility and potentiality of reviving Unani (Arab) medicine system in Kuwait (Ministry of Public Health 1977).  The 2 experts issued a 55-page report with 18 recommendations among which were: establishment of research institutes and libraries for Unani medicine, publication of a journal, cultivation of medicinal plants in Kuwait or their importation from India, Schools and medical colleges to teach this system of medicine. Two practitioners of Unani medicine. Razzack and Umm Fazal (1977) argued that ‘The Arab system of medicine is as much scientific as any other branch of modern knowledge... if by medical science we mean that branch of knowledge which treats diseases and provides their treatment in a systematic manner following a definite method in its experimental research, employing observations in deducing principles, testing deductive and inductive conclusions by experiments, pressing into its service the accumulated experience of ages in the various branches of knowledge’.

 

It is clear from the foregoing that there is nothing, Islamically speaking, to distinguish the unani system from any other traditional system of medicine. Razzack admits that the famous Greek physician, Hippocrates (460 BC) was the father of  unani medicine.  Arabs, Muslims and Indians added to it and developed it to what it is today.  It is not known to all Muslim societies. Some of the beneficial medicinal plants will not grow in other parts of the Muslim world.  It is confined to a particular time and particular place.  Islam and Islamic Medicine must be suitable for every place and every epoch. There is therefore no reason to label Unani Medicine as ‘Islamic’.  The best it can be called is Muslim medicine or medicine of Muslim societies.

 

ALTERNATIVE MEDICINE

Some authors have looked at “Islamic Medicine” as a reaction to and a complete rejection of modern western medicine.  Other authors have looked at natural therapeutics (diet, folk medicine, Hakim’s medicine, chiropractic, allopathy, naturopathy, naprapathy, and homeopathy) from an Islamic perspective and have argued that they are encouraged by Islam and are alternatives to drug therapy that has several limitation (Ali et al 1993). Including alternative medicine among perspective of Islamic medicine implies that the mainstream medical  system to which it is an alternative is non-Islamic.

 

SUPERSTITION AND MAGIC

In the centuries of decline, the concept of Islamic Medicine has sometimes, in ignorance, been reduced to magical practices, fortune telling, amulets, and talismans. Magic or sorcery have been mentioned in the Qur’an but the Qur’an is however very clear that magic cannot succeed (2:102, 21:3, 20:66, 113:4, 20:69, 36:77) and therefore cannot be beneficial medicine. Some people have claimed powers to deal with and control the jinns for medical or evil purposes. This is shirk and is rejected by Islam.

 

MEDICAL and SCIENTIFIC MIRACLES OF THE QUR’AN

Over the past 15 years efforts have been made to establish the ‘scientific miracles’ of the qur’an.  The World Muslim League set up an independent secretariat for this. Several international conferences, seminars have been held.  Many books and videos have been produced and have been used widely by dawa workers calling people to Islam. Murice Bucaille was one of the earliest authors to write about science and the Qur’an.  Other authors and investigators have ever since investigated several aspects: geology, astronomy, embryology etc. The most investigated aspect as far as medical science is concerned has been the field of embryology. This field intrigued ancient writers. Al Suyuti 1994) wrote about embryology and referred to the Qur’anic teachings on the matter.  Sheikh Abdul Majied al Zindani (Moore et al 1982) has been a leading scholar of embryology.  He has collaborated with leading embryologists and has high quality publications. The main finding has been the correspondence of Qur’anic with scientific observations. The concept of establishing scientific miracles of the Qur’an seems simple but has dangerous consequences and we have very strong reservations about its continuation. The stated reasons for the effort of establishing the scientific miracles can be inferred from the Islamic epilogue to the book by Moore and Zindani (1982, p. 458f-g) on embryology: “Allah gave signs to His messengers to prove their truthfulness. These were in the form of miracles which man cannot bring about.... Allah has preserved the Qur’an from any alteration and made its letters and words part of the miracle of the Prophet’s truthfulness. This miracle consisted of the Lord’s knowledge revealed literally in the Qur’an and by meaning in the hadith. As scientific knowledge advances we find that what has been discovered had already been mentioned in the Qur’an and Hadith a long time ago. This reveals to us that knowledge which came upon Mohammed (peace be upon him) must have come from Allah, as promised by Him (41:53)”.  Thus the miracle of the last of the Prophets is continuously renewed as time goes on..... The Qur’an has stated unequivocally, that the scholars (scientists included) are the ones who will know that it is the truth (34:6, 22:54, 2949)....  The words of the Maker are a great help to those who study the results of His work, the Qur’anic statements are therefore necessary to guide those who study Allah’s creatures’.

 

We feel that the Qur’an is its own best defense or proof. Its miracle is within it and does not require any external scientific investigation to prove it. Any attempt to compare the Qur’an and science or put the Qur’an side by side with science is comparing unequals. Science is not stable. What are facts and proved theories today turn out tomorrow to have been wrong.  Science is a product of human effort.  Besides deliberate fraud and falsification of research data, humans can make errors.  The Qur’an on the other hand is revelation.  No falsehood can approach it from any direction.  Its facts are absolute, objective and do not change with time or circumstances.  The very idea of trying to compare or relate 2 such unequal things is in our opinion not appropriate. Another very dangerous consequence of this exercise is that science can establish  a scientific fact in a verse of the Qur’an.  This is a strong motivation for a non-Muslim to believe in the truth of the Qur’an.  Suppose the science changes after some further research and the earlier theories are found no longer valid?  Will that disturb the belief of the individual concerned?  Will he lose confidence in science?. We therefore conclude that investigating scientific miracles of the Qur’an is at the least a questionable enterprise.  Before its long-term results are understood, it will be advisable not to include it among the active perspectives of Islamic medicine.

 

MEDICAL JURISPUDENCE, fiqh tibbi

Ijtihad on ethical, legal and moral issues in medicine is an area of current concern. Biomedical technology has given rise to many issues that are of medico-legal or ethical importance: contraceptives, sterilization, abortion, euthanasia, organ transplantation, artificial organs, amniocentesis for sex diagnosis, eugenics, genetic engineering, articifial insemination/in vitro fertilization, sperm banks, surrogate mothers, and ova banks (Ebrahim 1993, Bar 1985). Muslim physicians and fuqaha have been meeting to discuss these issues.  A seminar on Islamic views of some medical practices held in Kuwait in April 1978 and attended by both fuqaha and physicians discussed the following issues: sale of organs, cosmetic surgery, unfertilized ova, the length of the menstrual period and the length of gestation. The Islamic Fiqh Academy of the Organization of the Islamic Conference (OIC) has in its past 6 sessions discussed the following issues:  transplantation (reproductive organs, brain and nervous tissue), life support in terminal cases, milk banks, family planning and birth control, use of fetal tissue and organs in scientific experiments and organ transplantation. The Fiqh Council of North America has resolved similar issues. The problem encountered is that the physicians and fuqaha have different education backgrounds making it difficult for them to communicate effectively. Resolution of medico-legal and ethical issues lies at the intersection/interface of medicine and Islamic sharia. It is a legitimate occupation of a Muslim physician but cannot in itself be called Islamic medicine.

 

SOCIAL WELFARE and SOCIAL ADVOCACY

Providing services for the needy: Kasule (1982) in a paper titled ‘Islamic Medicine in Africa: New Perspectives and Challengers’ proposed and made a case for “a new dimension of Islamic medicine in its relevance to solving the health problems of the poor and least privileged people in the developing world”. Medical care fulfils one of the maqasid al sharia: preservation of life.  The Qur’an talks about the importance of life. (5:32). It is part of caring for others ‘he who does not care about condition of Muslims is not one of them’. Providing services is just one function of Islamic Medicine and would not be called Islamic Medicine.  Any system of medicine could provide service for the needy.  Therefore this is not a unique distinguishing characteristic.

 

Advocating or lobbying for the less privileged: Poor health on a global or even local levels is not due to absolute lack of medical resources but their maldistribution. Some have too much whereas others no access even to the most rudimentary of services. Dr. Omar Hasan Kasule, Sr. (1982) argued that “the health conditions of the poor of the world are desparate... participation in efforts to change these conditions for the better is a relevant, contemporary and future role for Islamic Medicine. With the present corpus of medical and scientific knowledge, most of the health problems can be solved. What is lacking is the will and compassion on the part of the global community to enable benefits of that knowledge to reach the needy”. Assuring access to care is one of the functions of an Islamized medical system but is not a unique defining characteristics.

 

Elimination of social causes of ill-health: Modification of behavior and lifestyle could eliminate a big proportion of disease. Malnutrition (excessive intake), alcohol and drug addition, sexual promiscuity are underlying causes of much ill-health both mental and physical. Islam has adequate guidance on how to deal with these social problems through the injunction of amr bi al maruf and nahy an al munkar. Ordering good and forbidding bad is a function of all people and organizations. Therefore we cannot cite this as a distinguishing characteristic of Islam Medicine.

 

D. ISLAMIC MEDICINE AS PARADIGMS, METHODOLOGY, & VALUES

The following definition of Islamic Medicine is proposed after consideration and rejection of the alternatives described above. Islamic Medicine is defined as medicine whose basic paradigms, concepts, values, and procedures conform to or to do not contradict the Qur’an and Sunnah.  It is not specific medical procedures or therapeutic agents used in a particular place or a particular time.  Islamic Medicine is universal, all-embracing, flexible, and allows for growth and development of various methods of investigating and treating diseases within the frame-work described above. This definition calls for basic transformation of current medical systems.  Islamic Medicine thus becomes the result of an Islamic critique and reformulation of the basic paradigms, research methodology, teaching, and practice of medicine. This process of conceptual transformation, also called Islamization of Medicine, is described below. The end-result of the Islamization process will not be a medical system for Muslims only but for the whole humanity because Islam is a set of universla and objective values.  Islamization is not theologizing, localizing of parochializing medicine but making it excellent for all.

 

The above-mentioned understanding of Islamic medicine is gradually changing the practice of medicine in the ummat. Islamic hospitals and clinics are being established in many Muslim and non-Muslim countries. There is increasing research inspired by the Islamic medicine movement. Medical faculties are being established on the same philosophy. In years to come, Muslim physicians will be able to make a marked impact on mainstream medical practice by introducing Islamic values to it.

 

E. THE NEED FOR REFORM IN MEDICINE

CONCEPTUAL and MORAL PROBLEMS

European medicine has some paradigms that we do not accept as Muslims.  Death is rejected as a natural phenomenon and resources are wasted in terminal illnesses.  Aging is also not accepted as a normal process and research is now being undertaken to reverse its course.  There is no balance and equilibrium in selecting treatment modalities.  Treatments are selected for their effectiveness against the condition without regard to what other harm they may cause to people  and the eco-system.  Some treatments of yesterday are the diseases of today.  Too much narrow specialization leads to lack of a holistic approach to the patient.  The physician turns a blind eye to moral and social issue of the day that affect the health of his patients and claims that his responsibility is medical care only. The secularized medicine has no consistent set of ethics.  Malpractice, fraud, physician misbehavior are common.  Materialistic pursuits are predominant. The highly secular environment does not acknowledge a spiritual or a religious dimension in medicine. There are biases in selecting, funding and publication of research.  Powerful political, economic forces that reflect the European world-view and philosophy of life are involved. The scientific method and its empirical observation was bequeathed to Europe by Muslims. The Europeans took the letter but not the spirit of the method. They proceeded to misused it by making empirical observation and experimentation the only source of knowledge to the exclusion of revelation.

 

PROBLEMS IN THE USE OF THE SCIENTIFIC METHOD

The scientific method has the following characteristics: (a) open-ended and self correcting; theories are abandoned if not sustained by facts (b) repeatability (c) consistency (d) verifiability (e) empirical knowledge is knowledge par excellence. European science’s origins can be traced to Egypt and ancient Mesopotamia.  It was passed on to the Greeks.  There was a decline of science in the roman era and suppression of scientific inquiry in the dark ages by the Catholic Church.  During the European dark ages, Muslims preserved and developed Greek science and systematized the empirical scientific methodology and passed their knowledge on to Europe just before renaissance. The renaissance was mainly this rediscovery of Greek knowledge.  Renaissance was accompanied by the rise of rationality, secularization, and loss of trust in organized religion in the form of the Christian Church.  This led European to misusing the scientific method by claiming that it alone was the source of valid knowledge to the exclusion of revelation.

 

The present use of the scientific method has several limitations that many physicians are not aware of:  limitations of observation, limited sources of knowledge, no positive moral context, no complete understanding of the human being, not being part of a holistic system and a parochial or local Euro-centric context. Human observation and senses have limitations in observing and interpreting phenomena. Some phenomena cannot be observed/perceived correctly. The priority assumptions, biases, and knowledge that the observer has affect the observation, perception and conclusions.  It is therefore wrong to rely on empirical observation as the sole source of knowledge. The two sources of knowledge in Islam are revelation, wahy, and the empirical world, kawn. Intellect, ‘aql, is a tool given to the human race to use both sources.  Western epistemology denies wahy as a source of knowledge. European epistemology is based on matter, denies religion or is sometimes actively anti-religion. It does not accept the unseen, al ghaib

 

MORAL PROBLEMS

European science denies morality as a factor in its work. It operates in a presumed moral vacuum. There is no recognition of absolute morality. It has adopted an even more dangerous concept. The attempt to solve social and medical problems of a moral or spiritual nature by use of technology. Empirical observation is in itself not sufficient to fully describe and understand the human being and his society.  Values, motivation, attitudes, beliefs are difficult to measure let alone understand from empirical study. The tools available to the scientist, human senses and instruments, extensions of senses, have an inherent inability to see the whole human picture.  Additional guidance and information from the creator, the all-knowing, is needed. Only Allah knows and understand humans fully. Thus knowledge of humans that can come only from revelation must be considered alongside the empirical observations for valid understanding.

 

PROBLEMS OF OBJECTIVITY

The scientific method has been directed to parochial and Euro-centric concerns and interests (political, military, economic). The priorities of research and application of knowledge are not based on objective and universal criteria. European epistemology pretends to be universal.  In practice it is parochial and reflects the cultural and religious heritage of Europe. Claim of objectivity by European epistemology is not true. Many of the so-called objective empirical observations actually reflect biases and presumptions of the western world-view. Science is fragmented with no overall holistic picture. Narrow specialization has led to rapid advances in scientific research but in the process only the trees are seen but not the forest.

 

Go to Part III

Omar Hasan Kasule, Sr.  October 2000