Paper presented at a seminar on the Signs of the Creator organized by Saba Islamic Media at Hyatt
Regency in Kuantan on 21st September 2002 by Prof Omar Hasan Kasule Sr. MB ChB (MUK), MPH, DrPH (Harvard).
PERFECTION, OPTIMALITY, INCOMPARABILITY
Allah’s creation is perfect. Allah is the best creator, ahsan al kahliqin. He perfected everything He made, kamal al khalq. He made humans in the best image, ahsan suurat. The process of perfection went through four stages: creation, khalq; making
due proportions, taswiyat; balancing, ta
‘adil; and making the best image, taswiir. The biological perfection
was created and not evolved. Every living and non-living things was created perfect de
novo. All what Allah created has a purpose. This applies to the whole organism or its constituent tissues and cells. Order, nidhaam;
harmony; and perfection, kamaal, are part of predestination, qadar, and are not accidental. Denying the existence of a creator is an intellectual and mental aberration
that is incompatible with logic because perfection and harmony could not arise by chance. The constant physical laws, sunan
al kawn, operate in both inanimate and biological systems. Every human
is unique and is different from everybody else, a testimony to the power of the Creator. The human is created in the best
and optimal fashion, ahsana taqwiim and all biological systems are optimal. Change is governed by natural laws, sunan
llah. There is a balance between constancy and change. The Qur’an challenged humans and other creations to create
the like of Allah’s creation and proved them incapable of facing the challenge. Cloning, genetic engineering, and selective breeding are not de novo creations
and can not be compared to Allah’s creations. No human or any other being can create new life, ‘ajz al shuraka ‘an al khalq. Human actions are imperfect.
Perfections of perfection and optimality are found in all medical disciplines. In anatomy, for example, parity in general, parity of gender, parity of organs, symmetry, both circular and lateral symmetry, laterality of left and right, adaptation of structure to function, consistency and predictability, and orderly
change (staged, anticipated, and protective measures against mistakes). Manifestations
of perfection and optimality in physiology, biochemistry, & pharmacology are: the human organism functioning as a single
entity, correlation between anatomy and physiology, repeatability/replicability, specificity, specialization, complementality,
co-operation, a hierarchy of importance, information processing/perception, reserve capacity in organs and compensation
for overload. The complex human organism
has few basic building blocks: amino acids, monosacharides, and fatty acids.The discovery of the periodic table of elements is one of the strong indicators
that there is order in the universe. Metabolism of new synthetic molecules is a miracle
of creation that needs appreciation. The finding that synthetic molecules
can be metabolized by the biological systems indicates the existence of a unifying scheme of creation based on sunan al laahi fi al kawn. In pathology, the concept of the common
pathway in cell injury relates well to the concept of sunan. Different injuries
to the cell cause the same or similar cell injuries, the common final path. Manifestations of perfection and optimality in
biostatistics and epidemiology areconsistency & predictability,
inference and causality, and probability.
There is centralized master
control of physiological functions mediated by the pituitary gland, the hypothalamus, and the CNS. This control has
a genetic basis in the form of DNA. DNA has 6x10e9 bits of information called
codons. These represent 10E7 genes. Each gene codes for one protein molecule. Command and control in physiology relate very well to the concept of tauhid. For efficiency
there must be a controlling center otherwise contradictions from many un-coordinated centers of control will lead to failure.
An orderly and harmonious universe cannot have more than one master. Examples of control are the integrity of DNA despite
continuous mitosis, normal cell growth, control of embryological development, control of balance (fluids, electrolytes, iron,
acid-base, heat energy, and temperature). There is balance between entropy (disorder) and order, between coagulation
and fibrinolysis, between sympathetic and parasympathetic systems, between left and right brain hemispheres, between anabolism
and catabolism. Chemical reactions tend to an equilibrium as defined in the Hasselbach-Henderson law.Phenomena of control manifest as control of the heart beat, control of vomiting, control of swallowing,
control of coughing, control of gagging, control of posture, control of micturition, control of defecation, control of lactation,
control of parturition, control of cell membrane permeability, control of genetic expression, and control of hormonal receptors.
Phenomena of periodicity manifest as cycling of matter between organic and inorganic and the circadian rhythm. Constancy and
predictability are the basis for diagnostic tests and drug action.
Qur’anic concepts relating to the golden mean are: mizan, wasatiyyat, moderation, tadafu’u, and I’itidal. The practical life and teachings of the prophet emphasize the concept of central tendency and avoiding either extreme.
WB Cannon coined the word homeostasis to refer to the ‘various physiological arrangements which serve to restore the
normal state once it has been disturbed. Mammals are able to maintain their internal environment within a narrow range. Tauhid and homeostasis are closely related.
Tauhid implies that the whole cosmos and what it contains have one deliberate creator. Thus all the contents must relate
to one another in some harmonious way. It is unthinkable that the one creator could create systems that are contradictory
to one another. The harmony must however be looked at in a dynamic way. Because there are constant changes, there must arise
from time to time contradictions in the state of flux. There must therefore exist mechanisms for restoring the status quo
after the changes have been accomplished. Human physiology illustrates dynamic stability amidst change by the mechanisms of
negative feed-back. The base-line is not constant. It changes with the environment and time to a new level of homeostasis.
Some changes are temporary whereas others are permanent. The internal and external milieu are in harmony despite the changes.
Cellular homeostasis is controlled centrally in the hypothalamus where the nervous and endocrine systems are integrated.
INTERACTION WITH THE ENVIRONMENT
The miracle of the human body is more startling when seen in its interaction with the environment. Internal and
external environments. The nervous and endocrine systems ensure that the human body can adjust to rapidly changing circumstances
of the external environment. This even includes changes on anticipation of external changes. The interaction between humans
and their external and internal environments is part of Allah’s grand design. The interaction is harmonious and follows
the laws of Allah sunan llah fi al kawn. The human body is programmed to interact
with the environment in the most efficient way. However humans because of their free will can behave in ways that produce
unhealthy interactions. There are some phenomena like disease or drought that may bring adversity to humans but are part of
the grand design to ensure that there are checks and balances in the eco-system that ensure equilibrium. The universe was
placed under the humans, taskhir. They control and change it as they want. However
this control is sometimes not proper resulting into imbalances and problems. The crucial question is to determine what changes
are bad because they derange the permanent fixed laws of nature, al sunan. A decision
must also be made on what changes must be made for purposes of building a civilization. The human body is able to adapt to
all types of physical environments. Humans are also able to engineer major changes in their air, acquatic, and terrestrial
environment. Some of the changes are for the good of the eco-system while some others are definitely harmful. Humans can sustain
injury from the environment. The physical environment consists of water, the soil, the atmosphere, and space and its starts
and planets. Human interaction with the biological environment (plants and animals) can be parasitic, symbiotic, or commensal.
Both animal and human structure and physiology are mutually adapted for the interaction. The microbial environment, consisting
of viruses, eukaryotes, and pro-karyotes, is more known as a cause of human disease but the benefits are often forgotten.
Human interaction with micro-organisms has been left undisturbed for all human history.Only in the past 100 years have humans been able to change transmission of organisms with microbial therapy and changes
in the habitat such as draining and spraying swamps. Genetic engineering is promising further dislocations by introducing
new organisms unknown before into the environment. Islamic teachings about personal and environmental hygiene relate to avoiding
microbial infections and limiting their spread. The chemical environment is both inside and outside the human organism. Human
tissues are made up of a few basic elements: H, C, I, O, P, S, K, and Ca. Humans have manufactured chemicals and drugs that
a profound effect on the chemical environment.
PATHOLOGICAL PROCESSES: repair & restoration of equilibrium, ruju ila
Pathological processes are a response to cell injury and are an attempt to
contain the damage and return to the normal. For example inflammation is protective. It destroys, dilutes, or walls off the
injurious agent. It is followed by the repair process. Both the inflammatory reaction and the repair process could be harmful
if they get out of control.