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ISLAMIC MEDICAL EDUCATION RESOURCES 04

0410-SAUM: BENEFITS and MEDICAL ASPECTS

Lecture given at the University of Brunei Darussalam on 14th October 2004 by Prof Dr Omar Hasan Kasule, Sr. MB ChB (MUK), MPH & DrPH (Harvard) Deputy Dean for Research UIA Kuantan MALAYSIA omarkasule@yahoo.com

1.0 INTRODUCTION

1.1 DEFINITION OF SAUM:

The Qur’an enjoined fasting[i]. Saum is a pillar of Islam, al saum rukn al Islam[ii]. If a person embraces Islam in Ramadhan he has to finish fasting the rest of the month, man aslama fi Ramadhan saama baaqi al shahr[iii]. Saum is voluntary denial of appetites that are normally permitted, al saum imtina’u ‘an al shahwat al mubaahat. The two appetites are for food and sex. The definition of saum as prohibition of entry of anything through any of the external body orifices is figurative but is true. Food and drink through the mouth are not allowed. Smoking and other inhalants are also forbidden. Sexual relations are strictly forbidden. All these prohibitions operate during the day light hours because saum is not obligatory at night.

 

1.2 RAMADHAN

The month of Ramadhan has a special standing amongst the rest of the months[iv]. The Qur'an was revealed in Ramadhan[v]. The first armed struggle in Islam between falsehood and truth at Badr was in the month of Ramadhan. The conquest of Makka was in Ramadhan of 8H. Jerusalem was liberated in Ramadhan 584H.

 

1.3 REGULATIONS & ETIQUETTE, AHKAM & ADAB AL SAUM

Start and end of Ramadhan is by sight of the crescent or by computation. The pillars of saum are intention and abstinence from food and drink. Its etiquettes are niyyat before fajr, delaying suhuur, hastening iftaar, iftaar on dates and water, and avoiding overeating at iftaar and suhuur.

 

Its permitted day acts are: using the miswak, bathing in water, applying kuhl, injection of medication, venupuncture, and washing the mouth and nostrils. Its recommended acts are salaat al tarawiih, i’itikaaf, dua at iftaar, charity, providing iftaar for others, joining kindred relations, recitation of the Qur'an, ghusl before salat al fajr, and avoiding three sins of the toungue: back-biting, lying, and obscenities. The prohibitions of saum are eating, drinking, and sexual intercourse.

 

Saum is nullified by deliberate eating or drinking, use of snuff or tobacco, excessive madhmadhat, excessive istinshaaq, insanity or loss of consciousness even if temporary, and penetration by any object into the body orifices (alimentary canal, the rectum, or the vagina), deliberate vaginal intercourse or any other sexual act that leads to orgasm, menstruation, post-natal bleeding, and masturbation.

 

Saum is not nullified by a wet sexual dream, cooling by tepid sponging, use of siwaak, use of toothpaste and toothbrush, and rinsing the mouth. The traveler can choose between saum and iftar but iftaar is preferred. Spontaneous vomiting does not require atonement but induced vomiting does. Use of hormones to delay menstruation and avoid breaking saum is not recommended.

 

2.0 REWARDS AND BENEFITS OF SAUM

2.1 REWARDS OF SAUM

Saum is an act of ‘ibadat with a lot of good, fadhl[vi] and reward, ajr[vii]. The reward of saum is with Allah, al saum li wa ana ajzi ‘anhu[viii]. The reward is more if saum is undertaken while on the path of Allah, sabiil al laah[ix]. Those who undertake saum will enter jannat through the gate of rayyaan, al saimuun yadikhuluun al jannat min baab al rayaan[x]. Saum will be an intercession in the hereafter, al saum shafa’at yawm al qiyamat[xi]. If a person undertakes saum in the month of Ramadhan in the true belief and expectation of reward from Allah, he is forgiven all the previous sins[xii]. Fasting the month of Ramadhan in Makka has special rewards, ajr saum ramadhan fi Makka[xiii].

 

2.2 SAUM AS SELF CONTROL

Saum has a positive impact on the individual. It is an ibadat that teaches self-control. It trains a person to survive without satisfying the usual desires, al siyaam tamrin ‘ala mukhalafat al hawa. A fasting person is able to control the food instinct, perhaps the most powerful human instinct. The sense of self-control gained is extendable to other situations of temptation to evil or when facing difficulties. Thus saum is described as protection, al saum junnat[xiv]. Saum is protection from sexual transgression for one unable to marry, al saum wijau li man lam yastati’u an baa’at[xv]. Saum helps in control of the sex drive[xvi]. Fasting is an exercise and training in patience[xvii]. Saum is half of patience, al saum nisf alk sabr[xviii]. It helps control of aggression. A person in saum who is insulted does not respond in kind but just says 'I am fasting'[xix]. Fasting helps control the tongue. A person undertaking saum who does not achieve this control gets not rewards from the fast[xx]. 

 

2.3 SAUM AS COMPASSION

Saum has the further advantage that it teaches compassion for the poor and the hungry in a practical way. The wealthy that fast taste of hunger and can appreciate the cry for help from the poor and less privileged. Without this obligatory fasting the wealthy would never taste physical hunger.

 

2.4 SAUM AS A CLEANSER

Fasting also cleanses the human from pride because he feels bodily weakness and his need for food and water. Saum cleanses the body, al saum zakaat al jism[xxi].  

 

2.5 SAUM AS A PLEASURE

The fasting person has two pleasures: when he breaks the fast and when he meets his Lord, li al saim farhataan[xxii]. The smell of the mouth of the person fasting is better to Allah than the best of perfumes, huluuf fam al saim[xxiii].

 

2.6 SAUM AS LIBRERATION FROM THE ROUTINES OF LIFE

Saum has a beneficial impact on the daily routine of life. It is surprising to many people to discover that their daily life routines are tightly controlled by the pattern of meals. A fasting person feels a sense of liberation in Ramadhan when the routines of daily life are changed. Ramadhan is therefore a time of stock taking when a person can look back in his her life when he or she is in a different mood.

 

3.0 MEDICAL ASPECTS OF SAUM

3.1 PHYSIOLOGICAL ASPECTS

Fasting does not make the body suffer to attain spiritual benefit. The concept of ascetism in this sense is alien to the Islamic creed. There is no spiritual advantage in punishing or persecuting the body or causing it any harm. The rights of the body must be respected in fasting[xxiv].

 

The Law provides guidelines on fasting for those who may suffer from physiological imbalances. The sick, the young, the travelers, pregnant women, menstruating women, breast-feeding mothers, and any other persons for whom fasting is an extra burden are excused from fasting or are asked to fast at a different time when they are physiologically competent. The law also provides for protection of conjugal rights of spouses[xxv].

 

When undertaken according to the teachings of the prophet, saum should not disturb the normal activities needed to work for feeding the family or undertaking ‘ibadat. It is offensive to treat the month of Ramadhan as a month of laziness.

 

3.2 FASTING IN HEALTH PROMOTION AND DISEASE PREVENTION:

Fasting also has health benefits. It purifies the body, al saum zakat al jism[xxvi]. Saum teaches control of the food appetite and prevents diseases of over-nutrition. It prevents sexually-related diseases by teaching control of the sex appetite.

 

Abundant epidemiological evidence has indicated that diet is a co-factor in heart diseases and cancer. People or communities with excessive intake of certain types of foods are at increased risk for these diseases. Tobacco is linked to lung and oral cancers. In all such cases there is weak will power to control appetite for food or tobacco.

 

Saum teaches appetite control. Its advantages should not be looked at only as deprivation of food for a limited time. The focus should be looked on the long-term benefits that a fasting person gets from strengthening will power and stopping eating or smoking even if they feel like to eat more.

 

3.3 FASTING IN DIFFICULT CIRCUMSTANCES

The elderly and patients with chronic or terminal illness are permanently excused from saum. They can choose to feed the poor instead or their heirs can make up their missed saum (qadha) if they die. Travelers, patients with curable illnesses, pregnant or breast-feeding women, women in haidh or nifaas are temporarily excused from saum but they have to make up (qadha al saum) before the next Ramadhan. Kaffaarat by feeding the poor is due if the next Ramadhan comes before the qadha. Saum in haidh or nifaas is invalid. More drinks are taken in hot weather to prevent dehydration and more food is eaten in cold environments to generate heat. Polar regions with long days or long nights follow the suhuur and iftar times of the nearest temperate region.

 

3.4 MEDICAL RULINGS ABOUT FASTING

Hypoglycemia and dehydration are prevented by prohibition of continuous saum, wisaal, and encouragement of early iftaar and late suhuur. Saum is exempted in physiological stress (haidh, nifaas, old age, illness, pregnancy, and breastfeeding). The following should be avoided: over-eating at iftaar and suhuur, and exposure to high temperatures. The following are encouraged: high fiber diets, adequate fluid and mineral intake, and cooling the body. Diabetics should consult trusted physicians before saum. The following do not nullify saum: drugs applied externally on the skin, eye drops, nose drops (if not swallowed), injections (sub-cutaneous, intra-muscular, and intra-venous), and sub lingual tablets. Elective medical procedure should be delayed until after saum. The following nullify saum: inhalants, nourishing i.v. injections, drugs taken orally or rectally.


[i]  (2:183-185)

[ii] (Bukhari K2 B34)

[iii]  (Ibn Majah K7 B52)

[iv]  (MB923)

[v] (2:185)

[vi] (Bukhari K30 B2)

[vii] (Bukhari K30 B2)

[viii] (Bukhari K30 B2)

[ix] (Bukhari K56 B36)

[x]  (Bukhari K30 B4)

[xi]  (Ahmad 2:174)

[xii] (Bukhari K2 B27)

[xiii] (Ibn Majah K25 B104)

[xiv] (Ahmad 1: 195)

[xv] (Bukhari K30 B10)

[xvi] (Bukhari K30 B10)

[xvii] (Kunuuz al sunnat S324)

[xviii] (Ahmad 4:260)

[xix] (Bukhari K30 B9)

[xx] (Bukhari K30 B8)

[xxi]  (Ibn Majah K7 B44)

[xxii] (Bukhari K30 B9)

[xxiii] (Bukhari K30 B2)

[xxiv] (Mukhtasar al Bukhari 961)

[xxv] (Mukhtasar al Bukhari 963)

[xxvi] (Ibn Majah K7 B44)

Omar Hasan Kasule, Sr. October 2004