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ISLAMIC MEDICAL EDUCATION RESOURCES 04

0301-PRAYERS AND SPIRITUALITY IN HEALTH

Lecture for 2nd Year Pharmacy Students on 26th June 2003 by Professor Omar Hasan Kasule, Sr.

SPIRITUAL MODALITIES OF TREATMENT:

Among spiritual approaches to disease management is use of dua from the Qur’an[i] and hadith as ruqiy. Dua was reported to have been used for madness, dua min al junoon[ii] and for fever[iii]. The formulas for ruqy reported from the prophet, al ruqiy al mathuur, consist of the following chapters of the Qur’an: al fatihat, al falaq, al naas, ayat al kursi, and the various supplications reported from the prophet, dua ma’athurat. The Qur’an is the best medicine[iv]. Dua is medicine[v]. Asking for protection from Allah, isti’adhat, is medicine[vi]. A strong iman and trust in Allah, tawakkul, play a role in the cure of diseases. Salat is a cure[vii]. 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.

 

SPIRITUAL DIMENSION OF SALAT

Salat is one of the pillars of Islam, al salat ahad arkaan al Islam[viii]. If a human knows that salat is an obligatory duty he is assured of entering paradise, man ‘alama anna al salat haqq waajib dakhala al jannat[ix]. Humans will be called to account for their salat in the hereafter before any other obligation, awal ma yuhasabu ‘alayhi al ‘abd al salat[x]. Salat is the most important formal act of ‘ibadat and is the summit of religion, ra asu al amr wa dharuwat sannamihi[xi]. It was ordained in heaven; the prophet had to make a special journey for this on the night of isra and miraa[xii]. Jibril taught the prophet the times and the number of prostrations, raka’ats, of each salat[xiii].

 

Establishing the 5 daily prayers is a source of reward, thawaab iqamat al salawaat al khams[xiv]. Observing the 5 prayers is a source of reward, ajr al muhafadhat ‘ala al salawaat al khams[xv]. The 5 daily prayers are also atonement, al salawaat al khams kaffaarat[xvi]. They are likened to river that flows by a house in which a person washes 5 times a day such that he is in a permanent state of cleanliness, nahar yaghtasilu fiihi khams marraat[xvii]. Salat is a cure, al salat shifaa’u[xviii].

 

Salat is direct communication with Allah[xix]. The 5 canonical salats are ordained at different times during the day and night so that the human can maintain regular almost continuous remembrance, dhikr, of Allah. The prophet used to stand in salat until his feet were swollen, kaana al nabiy yusalli hatta tanfakhu qadamaahu[xx]. He also found his calmness in salat, kaana qurrat ‘ayn al nabiy fi al salat[xxi].

 

Salat is so important that it is considered a distinguishing characteristic of Muslims. Salat is obligatory on adult, sane Muslims. True Muslims keep it all the time, muhafadhat ala al salat[xxii]. Deliberate refusal to pray puts the individual concerned outside the community of Islam. Neglect of salat is a great sin[xxiii]. Salat has advantages and a lasting impact on the individual[xxiv]. Regular salat protects the worshipper from committing evils ,fahishat &  munkar, and transgression[xxv]. Salat properly offered cleanses and expiates sins[xxvi]. The actions of qiyaam, sujuud, and rukuu[xxvii] are all direct actions of respect and reverence that the worshipper performs in front of the creator[xxviii]. Khushu[xxix] is necessary for validity of salat otherwise it becomes a series of routine physical movements with no purpose. The call for salat, adhan, has three elements: testimony of tauhid, testimonu of the message, risalat, and calling to success, falah.

 

SOCIAL ASPECTS OF SALAT

Salat has advantages for the society. Salat in congregation or in the mosque has the social advantage of bringing people together in worship and to strengthen their brotherhood. The call to prayer, adhan, is necessary to make sure that the whole community congregates[xxx]. The spirit of brotherhood and social organization is reflected in the requirement to straighten rows to stand shoulder to shoulder and to follow the imaam. The whole community meets five times a day in congregational prayer. The larger community meets once a week on Friday in salat al jum’at[xxxi]. An even larger gathering occurs during the 2 festival prayers, salat al eidain. Praying in congregation is so important that it is recommended that even if you have completed your obligatory prayer, you should repeat it as nafilat if there is a jamaat offering the same prayer. Facing the qiblat is a condition for validity of salat[xxxii]. The qiblat signifies the unity of the ummat and the unity of action since worshippers from all over the globe are acting in unison.

 

IMPACT OF ILLNESS OF IBADAT:

Impairment of consciousness: Forgetfulness in salat is remedied by the prostration of forgetting. A forgotten salat is offered when remembered. In complete loss of consciousness, there is no obligation to pray. In semi-coma, syncope, or stroke the patient tries to pray as much as they can. Stroke patients must be careful not to fall down during salat due to the limb paralysis or paresis. A dozing person stops salat, sleeps, and resumes when conscious of what he is reading. In fright or inability to concentrate, salat is shortened. A person who forgets and eats in Ramadhan just resumes fasting and completes the day. The obligation of fasting is dropped if the patient is in coma or is fully unconscious. Hajj is delayed if consciousness is impaired. Hajj rites are delayed in case of syncope following postural hypotension  Semi-conscious patients or those in coma are fed without their consent under the purpose of preserving life. Pronouncements of divorce or khulu’u, marriage, or contracts under psychosocial stress or impaired consciousness have no legal effect because of legal incompetence. However a guardian, wali, on behalf of the unconscious, can conclude valid contracts. Court testimony by a semi-conscious person is not allowed. There is reduced legal or civil liability for crimes and contracts under the influence of ordinary psychiatric medication. Liability is not reduced for crimes and contracts committed under the influence of alcohol or illegal drugs.

 

Personality disorders not accompanied by cognitive effects have no impact on ‘ibadat. Severe personality disorders exempt from hajj for fear of crises. Preventive measures are needed to protect the public from psychopaths. Severe personality disorders are a contra indication for marriage. Personality disorder may be considered as legal incompetence in contracts and criminal prosecution.

 

Neurotic and psychotic disorders: Obligatory salat is anxiety due to inability to concentrate. Compulsive-obsession about passing flatus in salat should be ignored. It may also cause forgetfulness in salat. Psychiatric disease does not affect the obligation of paying zakat because zakat is related to the wealth and the not the individual. Psychiatric illness that affects legal competence exempts from salat and hajj. Attempts are made to treat psychiatric illness before resort to divorce. A marriage contract is deemed void or irregular because of mental incompetence. Divorce pronouncements by an insane person have no immediate legal effect unless confirmed by a competent court. Contracts by a schizophrenic or a patient with mood disorders clouding clear thinking are void. Evidence by a psychiatric patient is evaluated in view of the type of cognitive or personality defects because some may be acceptable. The evidence of patients with mood disorders must be considered in the light of their clinical conditions.

 

Stress disorders: Stress can be controlled internally salat, dhikr, and i’tikaf. It may lead to wrong unintended decisions in transactions, produce adverse effects on marriage leading to divorce, affect appetite, and impair concentration in salat. Hajj and saum may increase the stress level. Salat generally decreases stress levels.



[i] (17:82)

[ii] (KS504 Ahmad 1:302) (KS504 Ahmad 1:302)

[iii]  (KS230 Tirmidhi K45 B36, 111, 118, Zaid H349, 350)

[iv] (KS338 Ibn Majah K31 B28, Ibn Majah K31 B41)

[v]  (KS338 Ahmad 2:446)

[vi] (KS338  )

[vii] (KS338 Ibn Majah K31 B10, Ahmad 2:390, Ahmad 2:403)

[viii] (KS83: Bukhari K2 B34; Bukhari K3 B6; Bukhari K9 B3; Bukhari K24 B1, Bukhari K24 B41, Bukhari K24 B63; Bukhari K30 B1,  Bukhari K52 B26, Bukhari K64 B60, Bukhari K64 B69, Bukhari K90 B3, Bukhari K97 B1, Muslim K1 H8, Muslim K1 H10, Muslim K1 H29, Muslim K1 H30, Muslim K1 H31, Abudaud K2 B1, Abudaud K9 B5, Abudaud K19 B20, Abudaud K25 B7;  Tirmidhi K5 B2, Tirmidhi K5 B6, Nasai K5 B4, Nasai K22 B1, Nasai 23 B1, Nasai K23 B46, Nasai K23 B73, Nasai K24 B1, Nasai K47 B23, Nasai K51 B48, Ibn Majah K5 B191, Ibn Majah K8 B1, Ibn Majah K25 B2, Darimi K1 B1, Darimi K2 B208, Darimi K3 B1, Muwatta K9 H94, Ahmad 1:250, Ahmad 1:264, Ahmad 1:361, Ahmad 1:382, Ahmad 3: 143, Ahmad 3:168, Ahmad 3:193,  Ahmad 4:200, Ahmad 4:384, Ahmad 5:368)

[ix] (KS308: Ahmad 1:60)

[x] (KS308: Tirmidhi K2 B188, Nisai K5 B9, Ibn Majah K5 B202, Darimi K2 B91, Muwatta K9 H89, Ahmad 1:161, Ahmad 1:177, Ahmad 2:290, Ahmad 2:425, Ahmad 4:65, Ahmad 4:103, Ahmad 5:72, Ahmad 5:377, Tayalisi H2468)

[xi] (KS237: Tirmidhi K38 B8)

[xii] (MB228)

[xiii] (KS308: Bukhari K9 B1, Bukhari K59 B6, Bukhari K64 B12, Muslim K5 H166, Muslim K5 H167, Abudaud K2 B2, Tirmidhi K2 B1, Nisai K6 B1, Nisai K6 B10, Nisai K6 B17, Ibn Majah K2 B1, Darimi K2 B2, Muwatta K1 H1, Zayd H109)

[xiv] (KS308: Nisai K5 B6, Ibn Majah K5 B194, Darimi K2 B108, Muwatta K7 H14, Ahmad 2:26, Ahmad 4:267, Ahmad 5:315, Ahmad 5:317, Ahmad 5: 319, Ahmad 5: 322, Tayalisi H573)

[xv] (KS308: Darimi K20 B12, Ahmad 2:169)

[xvi] (KS308: Tirmidhi K2 B46, Nisai K5 B7, Ahmad 1:402)

[xvii] (KS308: Bukhari k9 B6, Tirmidhi K41 B90, Darimi K2 B1, Muwatta K9 H91, Ahmad 1:71, Ahmad 1:177, Ahmad 2:379, Ahmad 2:426, Ahmad 2:441, Ahmad 3:305, Ahmad 3:317, Ahmad 3:357)

[xviii] (KS308: Ibn Majah K28 B10, Ahmad 2:390, Ahmad 2:403)

[xix] (MB331)

[xx] (KS308: Bukhari K81 B20, Ahmad 4:251, Ahmad 4:255, Tayalisi H694)

[xxi] (KS308: Nisai K36 B1, Ahmad 3:128, Ahmad 3:285)

[xxii] (p713: 2:238, 6:92, 23:9, 70:34, 107:4-5)

[xxiii] (107:4-5)

[xxiv] (p710-711: 23:1-2, 29:45, 31:4-5, 70:19-35, 87:14-15)

[xxv] (29:45)

[xxvi] (MB330)

[xxvii] (p564: 9:11248:29)

[xxviii] (23:1-2)

[xxix] (23:1-2)

[xxx]  (MB370)

[xxxi] (p712: 62:9-10)

[xxxii] (   )

Professor Omar Hasan Kasule Sr. January 2003