Lecture to 1st year students, Kulliyah of Medicine,
International Islamic University, Kuantan, MALAYSIA on Saturday22nd January 2000 by Professor Omar Hasan Kasule Sr.
5.5.1 STRATEGIES AND APPROACHES
A. Any Disease Is Potentially Curable
B. Cure Is From Allah:
C. Preventive Medicine (Tibb Wiqa’i):
D. Curative Medicine (Tibb ‘Ilaji):
E. Place Of Medical Treatment:
5.5.2 MODALITIES OF TREATMENT
C. Multiple/Combination Of Spiritual And Physical:
D. Halal Therapeutics
E. Haram Therapeutics
5.5.3SIDE-EFFECTS OF MEDICATION VS BENEFITS
B. Side Effects
C. Harm Due To Manner Of Use
D. Balance Of Harm And Benefits
E. Misuse Of Medicine
A. Harm Of Superstition
1.0 STRATEGIES AND APPROACHES
A. ANY DISEASE IS POTENTIALLY CURABLE
Every disease has a treatment (KS p. 338). The prophet Muhammad (PBUH) said in an authentic hadith
that Allah did not reveal any disease, bau, without also revealing its cure, dawau, (MB #1962). Humans are encouraged to seek treatment (MB#1962, KS p. 338). The
Qur’an described cure, shifa (p 637 , 5:110, , , 10:69, 17:82, 26:80, 41:44). The Qur’an is a itself a cure (17:82). Honey is described in
the Qur’an as a cure (16:69). some people may know the cure and others may ignore it but it nevertheless exists. The
Qur’an described disease in prophet Ayyub (PBUH) and its eventual cure (21:83-84, 38:41-44). The Qur’an described
how Isa cured chronic diseases (, ).
B. CURE IS FROM ALLAH:
Humans try, but it is Allah who cures, allah huwa
al shafi (p 1105 21:83-84, 26:80, 38:41-42). Humans should not be arrogant by attributing cure to themselves and not Allah.
In the same way humans can not refuse to take measures to cure disease claiming that Allah will take care of it. It is true
that Allah cures but in some cases that cure operates through the agency of humans. Sometimes the measures that humans take
to cure a disease may not be sufficient on their own to alleviate the condition; it is Allah’s divine intervention and
mercy that brings about the complete cure.
Disease treatment is part of qadar (KS P. 338).
Seeking treatment does not contradict qadar or tawakkul.
Disease treatment ispart of qadr.
The principle that applies here is reversal of qadar by another qadar (rad al qadr bi al qadr).
C. PREVENTIVE MEDICINE (TIBB WIQA’I):
Preventive medicine is a pro-active measure. The Qur’an has used the concept of wiqaya in many situations to refer to taking preventive action against entering hell-fire,
wiqaya min al nar), against punishment, wiqaya
min al adhaab (p 1316 2:201, 3:16, 3:191, 3:34, 13:37, 40:7, 40:9, 40:21, 44:56, 52:18, 52:27, 70:11),against evil, wiqaya min al sharr(p 1316 86:11), against greed, wiqaya min al shuhhu (p 1316
59:9, 64:16), against bad acts, wiqayat min al sayi’at (p 1316 40:9, 40:45),
against injury/harm, wiqayat min al adha, (p 1316 16:81), against jealousy, wiqayat min al hasad), against oppressive rulers, wiqaya
min al taghoot (p 1316 3:28), against annoyance, wiqayat min al adha (p 1316
16:81),and against heat, wiqayat min
al harr (p 1316 16:81).
Prevention is therefore one of the fixed laws of Allah in the universe, sunan llah fi alkawn. Its application to medicine therefore becomes most obvious.
Disease could be prevented before occurrence or could be treated after occurrence. The
concept of prevention, wiqayat, does not involve claiming to know the future or
the unseen, ghaib, or even trying to reverse qadar.
The human using limited human knowledge attempts to extrapolate from the present situation and anticipates certain disease
conditions for which preventive measures can be taken. Only Allah knows for sure whether the diseases will occur or not. The
human uses knowledge of risk factors for particular diseases established empirically to predict disease risk. Preventive action
usually involves alleviation or reversal of those risk factors. For example stopping cigarette smoking can prevent lung cancer
and ischemic heart disease. Obeying fire regulations can prevent fire accidents. Careful driving prevents road traffic accidents
and trauma. Immunization prevents viral and bacterial infections.
The concept of prevention can be understood at three levels. Primary prevention aims at
making sure the disease does not occur at all. Secondary prevention aims at limiting the impact of the disease once it has
occurred; this is usually by attempting to detect the disease early and instituting necessary treatment. Tertiary prevention
aims at mitigating the long-term sequelae and complications of a disease. Prevention also involves avoiding any act that can
hurt good health or destroy life, halaak (p 1261 4:176 … 67:28). There are
activities that promote good health and are part of preventive medicine because they put the body in the best possible status
to be able to fight and overcome any disease that occurs. Examples of such activities are: physical exercise,rest and recreation, diet, dhikr llah,happy marriage and good family life.
D. CURATIVE MEDICINE, tibb ‘ilaji:
Every disease has a cure that must be searched for and used (MB 1962). Curative medicine
may be invasive or non-invasive. Where possible non-invasive approaches are preferred because invasive disease treatment whatever
its nature involves some element of risk to the patient. This risk is higher the more invasive the treatment modalities are.
A non-invasive approach that aims at helping or assisting the body to fight the disease is the best. Many physicians forget
the tremendous potential that the body has to take care of itself and cure disease with the help of Allah. Medical treatment
in most cases should be supportive to the body’s natural healing processes. The body’s defenses against foreign
bodies are in the immune system which may be humoral or cellular. Given the chance to fight back, the body is able to repair
damaged tissue with time.
E. PLACE OF MEDICAL TREATMENT:
For millenia the home has been the site of treatment. Increasing sophistication of medical treatment
eventually led to opening hospitals. The first hospital in Europe was Hopital de Dieu opened in Paris in 600 AD. The first Muslim hospitals, bamirstans, were
opened before that. For a long time hospitals were looked at as places where people went to die and not places for recovery.
The bad reputation arose from the fact that most of those who went to hospitals did not return. The situation has now improved.
With available medical technology the hospital makes a major difference.
2.0 MODALITIES OF TREATMENT
Among spiritual approaches to disease management is use of dua from the Qur’an (17:82) and hadith as ruqiy (KS p. 504). The
Qur’an is the best medicine (KS p. 338). Dua is medicine (KS p. 338). Asking
for protection from Allah, isti’adhat, is medicine (KS p. 338). A strong
iman and trust in Allah, tawakkul,play a role in the cure of diseases. Salat is a cure (KS p. 338).The spiritual approach to cure is mediated through the physical processes.
Psychosomatic processes affect the immune functions and other metabolic functions of the
body. A believer who is spiritually calm will have positive psychosomatic experiences and not negative ones because he or
she will be psychologically healthy and at ease. Faith can change the very perception of disease symptoms. Pain is for example
subjective. A believing person who trusts in Allah may feel less pain from an injury than a non-believer with the same injury.
Among physical approaches to disease management are: diet,natural agents (chemical, animal and plant products),manufactured chemical
agents, surgery, jiraha, and physical treatment e.g. heat. Physical approaches
can reverse disease pathology,mitigate its effects or just stop farther progression.
C. MULTIPLE/COMBINATION OF SPIRITUAL AND PHYSICAL:
There should no dichotomy between spiritual and physical modalities of treatment. Both
approaches should be used for the same condition; they are complementary. Each cures the disease each using a different pathway.
There is no contradiction but there is always synergy. It is a mistake to use one and reject the other.
D. HALAL THERAPEUTICS
All therapeutic agents and procedures are allowed unless they contravene a specific provision
of the law. This provides a wide scope for the practice of medicine
E. HARAM THERAPEUTICS
Bad medicine is forbidden (KS p. 341). Bad medicine causes more harm than benefit. While
seeking treatment, the moral teachings of Islam must be respected. The end never justifies the means. Haram material is not
allowed as medicine except in special circumstances where the legal principle of necessity, dharurat, applies. Alcohol is for example not an accepted cure for any disease; it is actually itself a disease.
3.0 SIDE-EFFECTS OF MEDICATION VS BENEFITS
The discovery of antibiotics and other powerful agents and procedures effective against
disease has changed the face of medical care for the better in the past 50 years but has brought with it many iatrogenic problems.
B. SIDE EFFECTS
They are always associated with side-effects or unwanted effects that a good physician
should be aware of and should look out for. These problems are two-fold: (a) introduction of new molecules in drugs into the
body and the environment. The long-term effect of such ‘unnatural’ molecules is not known. (b)Invasive technology makes drastic changes to human anatomy and physiology with its long-term consequences
C. HARM DUE TO MANNER OF USE
The practitioners of homeopathic medicine rightly criticize allopathic medicine for its
aggressive approach that is associated with many side-effects and unwanted effects in the long and short terms. Homeopathic
medicine,practiced in some societies and thought to have less side effects,
is clearly less effective for most conditions.
D. BALANCE OF HARM AND BENEFITS
Harmful treatments are not allowed in situations in which the cure is worse than the disease.
Choice of what treatmentmodality to use should involve a careful weighing of
benefits and possible harm or injury. It is a principal of Islamic law, sharia,
to give priority to preventing harm over accruing a benefit.
The equilibrium between benefit and harm of treatment modalities should be looked at using
three Islamic principles: tauhid, wasatiyyat, & shumuliyyat. The concept of
tauhid motivates looking at the patient, the disease, and the environment as one
system that is in equilibrium; thus all factors that are involved with the three elements are considered while making decisions.
The concept of wastiyyat motivates the need for moderation and not doing anything
in excess. The concept of shumiliyyat extends the tauhidi principle by requiring an overall comprehensive bird’s view of the disease and treatment situation.
E. MISUSE OF MEDICINE
Evil people use pharmacological agents for bad and selfish reasons for example in altering
people's minds to deliberately cause harm.
A. HARM OF SUPERSTITION
Many people with disease conditions resort to superstition, magic, sorcery and divination.
These superstitions nullify ‘aqidat al tauhid. Superstition is distraction
from seeking true treatment. Patients delay coming to hospital and by the time they come the disease is too advanced for easy
Shirk arises when humans seek and expect cure of disease from anything other than Allah.
Manifestations of shirk practices in disease treatment include: amulets, ,tamaim,,
divinations, kahanah, and worshipping or asking cure from humans calledsaints, awliyaa,, by
visiting their graves. Other superstitious practices usually associated with shirk
are: claiming knowledge of the unseen and claiming supernatural powers by any human. A fortune teller, kahin, is a liar who pretends to know the future or the unseen and provides information to the gullible clients.
Talismans are a form of shirk.There are people
who hang objects on their body, azlaam, for
protection instead of relying on Allah (p 97 5:3, 5:90). Such actions are very demeaning to humans. How can a human who possesses
an intellect rely for protection on a small object that he manufactures himself and hangs around his neck?
Dreams, ru’yat manamiyat (p 516 8:43, 12:4-6, 12:36,
12:43-44, 12:100, 21:5, 37:102, 37:105, 48:27, 52:32) Superstition could also be in the form of dreams and their interpretation
(tafsir al ahlam). It is true that humans dream. Most dreams are related to the
daily human experiences. Sometimes because of the state of sleep the facts become distorted such that a person can not relate
the dream or understand it. In such cases the Qur’an tells us that only Allah knows for sure the correct interpretation
of dreams. Limited ability to interpret dreams was given to some prophets (p 221 12:6, , -37, -49, 12:100-101). Other humans do not this ability.
D. SORCERY, sihr: Some people practice witchcraft
or sorcery, sihr. The Qur'an condemns and forbids sorcery in all its forms and
manifestations (p 1248 113:4, p 566 2:102, 2:102, 5;110, 6:7, 7:109, 7:112-113, 7:116, 7:120, 7:132, 10:2, 10:76-77, 10:79-81,
11:7, 15:15, 17:47, 17:101, 20:57-58, 2:63, 20:66, 20:69-73, 21:3, 23:89, 25:8, 26:34-38, 26: 40-41, 26:46, 26:49, 26:153,
26:185, 27:13, 28:36, 28:48, 34:43, 37:15, 38:4, 40:24, 43:20, 43:49, 46:7, 51:31, 51:52, 52:15, 54:2, 61:6, 74:24). Sorcery
and its practice are superstitions that believers should avoid.
Astrology, tanjim: Astrology is the belief that movement of planets, stars, the sun, the moon can affect peoples’
lives. The astrologer uses these phenomena to make predictions about disease or its cure. The astrologer, munajjim, is a liar because he or she is trying to appropriate Allah’s prerogative of knowing the unseen,
Tatayyur (p 755 7:131,27:47, 36:18-19)
Involvement of jinn and shaitan: Jinn possess power that is used to misguide and give credibility to shirk and superstition. The jinn do not
know the unseen ( p 289-9 -18, 34:14, 37:6-10, 67:5, 72:8). A good Muslim should not be involved with jinns and should ask Allah for protection against them (p 288 , 7:200, 16:98, 114:1-6).
1. Describe the forms of traditional treatment in your community
2. What are the commonest superstitions in your community
3. Discuss the benefits against the risks for three Invasive procedures that you know
4. Define iatrogenic disease. How common is it?
5. What is your opinion about the right of a patient to refuse treatment
6. What are the various understandings of Islamic medicine prevalent in your community
7. Is it true that medical treatment does make a difference in all conditions?
8. What is the rationale for medical treatment for terminal patients