0703-The Approach of Quran & Sunnah in Medicine: Challenges & Practice in the Era of Globalization
by Prof Omar Hasan Kasule Sr. MB ChB (MUK), MPH (Harvard(, DrPH (Harvard) Professor of Epidemiology and Islamic Medicine Universiti
Brunei and Visiting Professor of Epidemiology at the Faculty of Medicine Universiti Malaya at Dhakka on 30th March
2007. EM firstname.lastname@example.org, WEB: http://omarkasule.tripod.com.
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 characterized by being value-based, by being
holistic under the tauhidic paradigm, and by conforming to the 5 purposes of the
Law, maqasid al shari’at. The Qur’an and sunnat have guidelines for the treatment and cure of diseases. The appeal of the concept of Islamic medicine is
set to grow phenomenally in the next 20 years. This growth will be driven by two main forces: defining Islamic alternatives
in many fields of endeavor and general dissatisfaction with modern scientific medicine because of over-emphasis of technology
over the human dimension. The Islamic approach to medicine has reintroduced the human element in medicine without denying
the benefits of modern medical technology. Islamic hospitals and Islamic faculties of medicine are being built. The Islamic
health care industry is expected to experience phenomenal growth. The strict and exclusive monotheism of Islam is a basis
for a global perspective in medicine and will help make Islamic medicine a global player not limited by geography or ethnicity.
1.0THE ISLAMIC MEDICINE MOVEMENT
1.1 Definition of Islamic medicine as paradigms and values
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.
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 is called Islamization of Medicine. 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 universal and objective values. Islamization is not theologizing, localizing of parochializing medicine but making it objective,
universal, value-based, and excellent for all.
1.2 Impact of Islamic Medicine
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
1.3 The motivation behind Islamic Medicine: conceptual and moral problems
European[i] 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. There
is no consideration of balance and equilibrium in selecting treatment modalities with the result that an unacceptably high
number of patients are being treated for side effects of modern therapeutic agents. Too much narrow specialization leads to
lack of a holistic approach to the patient. The physician behaves as a technician 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. Secularized medicine
has no consistent set of ethics leading to malpractice, fraud, and bias in research. Accepting only empirical knowledge and
negating other sources of knowledge had also created new problems. By denying a religious and moral dimension, European medicine
operates in a presumed moral vacuum. It is a gross mistake to attempt to solve social and medical problems of a moral or spiritual
nature by use of technology.
2.0TAUHID AS THE BASIS FOR A GLOBAL OUTLOOK IN MEDICINE
2.1 Basic tenets of ‘aqidat al tauhid
Islam is strictly and exclusively monotheistic. Judaism is also monotheistic but in practice
negates monotheistic universality by being an ethnic faith. Christianity has a qualified monotheism. That leaves Islam with
absolute monotheism that translates directly into universal social behavior and social organization. The essence of monotheism,
tauhid, is the oneness of the creator, wahdaniyyat al llaah[ii]. Belief in the one-ness of the Creator-God, tauhid al rububiyyat,
explains the harmony and coordination in the universe created by one God. Tauhid al uluhiyyatimplies worship of one God alone. Worship of only one God implies
following the Creator’s physical and social laws that make life on earth successful.
2.2 Implications of tauhid
Tauhid encapsulates the Islamic world-view, al
tasawwur al islami, and is the basis of Islamic culture and civilization. It provides an integrating framework for the
whole universe in whose absence there would be irreconcilable contradictions. It is the basis for consistent and uniform physical
and social laws that govern science, technology and society. Tauhid explains the unity and brotherhood of mankind because of a common origin[iii]. The differences of nations and tribes have the purpose of mutual identification[iv] and do not negate the common human brotherhood.
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.
Tauhid also motivates looking at a patient as
one organism and not a convenient combination of organs and pathologies. The patient has physical, social, psychological,
and spiritual dimensions that have to be considered together in an integrated and holistic fashion.
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.
3.0PURPOSES OF THE LAW AS THE ETHICO-LEGAL BASIS OF MEDICINE
3.1 The Theory of maqasid al shari’at
Islamic Law has
5 main purposes. Ethical practice of medicine fulfills and does not contradict those purposes. They are: protection of life,
hifdh al ddiin; protection of life, hifdh
al nafs; protection of progeny, hifdh al nasl; protection of the intellect,
hifdh al ‘aql; and protection of wealth, hifdh
3.2 Protection of ddiin, hifdh al ddiin
ddiin essentially involves ‘ibadat
in the wide sense that every human endeavor is a form of ‘ibadat. Thus medical
treatment makes a direct contribution to ‘ibadat by protecting and promoting
good health so that the worshipper will have the energy to undertake all the responsibilities of ‘ibadat. The principal forms of physical ‘ibadat are the
pillars of Islam: prayer, salat; fasting, siyaam;
and pilgrimage. A sick or a weak body can perform none of them properly. Balanced mental health is necessary for understanding
‘aqidat and avoiding false ideas that violate ‘aqidat.
3.3 Protection of life, hifdh al nafs
The primary purpose
of medicine is to fulfill the second purpose of the shari’at, the preservation
of life, hifdh al nafs. Medicine cannot prevent or postpone death since such matters
are in the hands of Allah alone. It however tries to maintain as high a quality of life until the appointed time of death
arrives. Medicine contributes to the preservation and continuation of life by making sure that the nutritional functions are
well maintained. Medical knowledge is used in the prevention of disease that impairs human health. Disease treatment and rehabilitation
lead to better quality health.
3.4 Protection of progeny, hifdh al nasl
to the fulfillment of this function by making sure that children are cared for well so that they grow into healthy adults
who can bear children. Treatment of infertility ensures successful child bearing. The care for the pregnant woman, peri-natal
medicine, and pediatric medicine all ensure that children are born and grow healthy. Intra-partum care, infant and child care
ensure survival of healthy children.
3.5 Protection of the mind, hifdh al ‘aql
plays a very important role in protection of the mind. Treatment of physical illnesses removes stress that affects the mental
state. Treatment of neuroses and psychoses restores intellectual and emotional functions. Medical treatment of alcohol and
drug abuse prevents deterioration of the intellect.
3.6 Protection of wealth, hifdh al mal
The wealth of
any community depends on the productive activities of its healthy citizens. Medicine contributes to wealth generation by prevention
of disease, promotion of health, and treatment of any diseases and their sequelae. Communities with general poor health are
less productive than healthy vibrant communities.
4.0MEDICAL GUIDELINES IN THE QUR’AN AND SUNNAH
The Qur’an is a book of moral guidance that provides general principles that guide the development of knowledge
in various disciplines. It therefore does not go into details about disease. The Qur’an is itself a cure[v]. Honey is described in the Qur’an as a cure[vi]. The Qur’an described disease in prophet Ayyub (PBUH) and its eventual
cure[vii]. The Qur’an describes how Isa cured chronic diseases[viii]. Humans try, but it is Allah who cures, allah
huwa al shafi[ix].
4.2 Prophetic medicine
We find more details
about medicine in the hadiths of the Prophet. 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 (d. 430 AH), IbnQayyim al Jawziyat (d. 751 AH), and Jalaluddin al Suyuti(d.
911 AH). There are also more recent writings as articles and books.
Muhammad (PBUH) said in an authentic hadith that Allah did not reveal any disease, bau,
without also revealing its cure, dawau[x]. Humans are encouraged to seek treatment, al hatthu ‘ala al dawaa[xi].Some people may know the cure
and others may ignore it but it nevertheless exists. 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 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 to prevent fire and pests, and leaving a country because of its water
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. Curative medicine involved prophetic teachings about treatment of wounds, use of honey and
the black seed for several ailments. 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
In his book, A
Tibb al Nabawi, Imaam Ibn al Qayim 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. Diseases
in tibb nabawi treatable by natural remedies were listed as: 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.
Ibn al Qayyim
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.
4.3 Spiritual modalities of treatment
approaches to disease management is use of dua from the Qur’an[xii] and hadith as ruqiy. Dua was reported to have been used for madness, dua min al junoon[xiii] and for fever[xiv]. The formulas for ruqy
reported from the prophet, al ruqiy al ma’athuur, 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[xv]. Dua is medicine[xvi]. Asking for protection from Allah, isti’adhat,
is medicine. A strong iman and trust in Allah, tawakkul, play a role in the cure of diseases. Salat is a cure[xvii]. 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.
4.4 Physical modalities of disease treatment
Ibn al Qayyim
mentioned three therapeutic modalities used in Prophetic medicine: natural, spiritual, mixture of natural and spiritual. The
physical treatments mentioned were honey, al 'asal; cold water for fever, al mau al barid;, diet, ghadha;, milk, al laban;, camel milk, camel urine, cupping, al hijaam;, cauterization,
al kayy;, venesection with cauterization, qati’u
al uruuq wa al kayy;. The black seed, al habba al sauda, was especially emphasized.
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. 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. Bad medicine
is forbidden[xviii]. 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.
are not allowed in situations in which the cure is worse than the disease. Choice of what treatment modality 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.
Evil people use
pharmacological agents for bad and selfish reasons for example in altering people's minds to deliberately cause harm.
4.5 Prohibition of shirk in seeking cure
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. Many people with disease conditions resort
to shirk practices due to misguidance by shaitan.
These practices nullify ‘aqidat al tauhid because they attribute disease and its cure to other than Allah. They also distract from seeking true treatment
based on rational scientific medicine. Patients delay coming to hospital and by the time they come the disease is too advanced
for easy cure.
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[xix]. A good Muslim should not be involved with jinns and should ask Allah for protection against them[xx].
kahin, is a liar who pretends to know the future or the unseen and provides information
to the gullible clients. The prophet forbade consulting fortunetellers, al nahyu ‘an hawlaan al kaahin, al nahyu
‘an istishaarat al kaahin[xxi]. Fortunetellers are able to convince their clients about supernatural
knowledge because of assistance by shaitan that listens to people’s secrets
and informs the fortuneteller, istishraaq al shaitan al sama’u[xxii].
Astrology, tanjim, is the belief that movement of planets, stars, the
sun, and 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, ghaib. Astrology was forbidden by Islam, al nahyu ‘an al tanjiim[xxiii].
mentioned in the Qur’an[xxiv]. Divination is foretelling the future using several techniques such as horoscopes, astrology, geomancy (use of figures
or lines), crystal gazing, possession by a spirit that answers specific questions, pyromamcy (divination by fire), hydromancy
(divination by water), cleromancy (divination by lots), somatomancy (divination based on body appearance), phenology (divination
by features of the head), and oneiromancy (interpretation of dreams). Augury is divination of the future by observation of
natural phenomena in plants, animals, or inanimate objects to see omens (divinatory signs).What is surprising is that
spread of modern science based on empiricism has not done away with the superstitution of divination. It is also surprising
that those who consult diviners do not test the predictions of the diviners but just believe them or ignore them and never reach the conclusion that diviners do not know or just guess.
Amulets / talisman are objects thought to bring good fortune or to prevent disease. They may be natural or man-made.
They may be of plant or animal origin. Some are made of stone or metals. They are thought to have magical powers. Talismans
are forms of shirk, al tamaim shirk[xxv] and it is offensive to carry them, karahiyat haml al tamaim[xxvi].There is no difference in prohibition between talismans from the Qur’an and those from other sources.There are people who hang amulets, azlaam, on their body for protection instead of relying on Allah[xxvii]. 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?
4.6 Medicine and pre-determination, qadar
is part of qadar[xxviii]. Seeking treatment does not contradict qadar or tawakkul. Disease treatment is part of qadr. The principle that applies
here is reversal of qadar by another qadar,
rad al qadr bi al qadr. 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.
5.0 THE ISLAMIC HEALTH INDUSTRY: PROSPECTS AND CHALLENGES
5.1 The Islamic Medicine alternative
appeal of the concept of Islamic medicine is set to grow phenomenally in the next 20 years. This growth will be driven by
two main forces. The first one is the general process of defining Islamic alternatives in many fields of endeavor. For example
Islamic banking has expanded to all countries of the world being recognized and catered for by the Bank of England and virtually
all banking giants that are not in any way describable as Muslims. Many of these banks have set up special accounts and special
windows to handle Islamic banking and the industry is worth billions with the prospect it shall soon be worth trillions.
second driver is the general dissatisfaction with modern scientific medicine. This dissatisfaction is evidenced by the phenomenal
growth of alternative traditional of complementary (TCM) medicine. The disadvantage of the TCM movement has been denying a
large number of patients the powerful curative modalities of scientific medicine. People turn away from scientific medicine
not because of its technology but because of its lack of a human dimension.The
growing popularity of Islamic medicine is that it has reintroduced the human element in medical practice without missing out
on the benefits of modern medical technology. This popularity is witnessed by building of Islamic hospitals in many parts
of the world. The medicine practiced in these hospitals is as modern as is found in the best medical centers in New York and London but has the added
value of a human dimension that gives patients so much satisfaction. It is for these reasons that we have included some elements
of Islamic medicine in the undergraduate medical curriculum to prepare our students to be players in an industry that is billed
to grow phenomenally in subsequent years.
THE CHALLENGE OF GLOBALIZATION
7.1 Lizard hole phenomenon
Prof Malik Badri talked about the Lizard Hole phenomenon based on the hadith of
the prophet that Muslims in later times would follow non-Muslims like lizards follow one another into lizard holes[xxix]. Creators of lizard holes want to retain intellectual leadership and
initiative. They create new lizard holes so fast that they do not have enough new ideas for them. Old ideas have to be recycled
and labeled as new ones using different terminology and words. Globalization is one of the lizard hole phenomena that is as
old as human history but is being presented today as a new phenomenon and as an addition to the lizard holes that Muslims
are being persuaded to enter. Since we know it is old and not new we should spent time examining it critically instead of
just entering the lizard hole.
7.2 Globalization before the 15th century of hijra
Globalization is not new. The inhabited world has always been global. Humans
created from Adam and Hawa have walked on their feet to far corners of the world where humans live today. The evidence for
these wide-scale human movements is still preserved for us today. Physical anthropologists can trace the spread of humans
by studying physical and genetic characteristics along the routes of migration. Cultural anthropologists can make similar
studies using linguistic tools. Thus humans before and after history have been moving around and interacting with one another
genetically, culturally, politically, religiously, and commercially.
7.3 Globalization in the 15th century of hijra
Globalization in the 15th century H differs from ancient globalization
in having faster communication and movement. Ancient communication was 2-way with mutual influence on one another. Modern
globalization is one-way transfer of information and culture from the industrialized countries to the less industrialized.
Economically cheaply-priced raw materials flow from the less industrialized countries to the more industrialized while fewer
economic benefits flowing in the opposite direction.
7.4 The future of globalization
The laissez-faire attitude to globalization will continue as long as it is
comfortably one-way. When demographic, social, economic, and ideological trends start forcing a reversal of the flow of information,
culture, ideology, and economic initiative in the opposite direction, industrialized countries will respond by curtailing
or shutting down globalizing trends. The first victim of the shut-down will be the internet.
7.5 The challenge of globalization in medicine
skills, and technology flow from the industrialized countries. The less industrialized ones are consumers and not producers
of medical knowledge. The challenge is to reverse this unhealthy trend by a vigorous research program to be producers of knowledge.
8.0 IBN SINA and THE CHALLENGE OF GLOBALIZATION
Ibn Sina in whose
honor this lecture is being given lived at a time similar to our times. Greek knowledge and science were dominant. Ibn Sina
studied all the available medical knowledge and went on to research and add onto that knowledge. He therefore exemplified
the ideal we need today. He was a producer and not a consumer of knowledge.
Al Shaikh al Rais Abu Ali Al Hussain Bin Abdillah Bin al Hassan Ibn Sina (370-428 H / 980 – 1037 CE) wrote
many books the most famous being al Qanuun fi al Tibb, a 14-volume encyclopedia on disease classification and causes, therapeutics,
simple and compound medicines, hygiene, and functions of the body. The book was translated into Latin and had a major impact
on western medicine being taught until the 18th century CE. Ibn Sina recognized that TB was contagious. He accurately
described the symptoms of diabetes mellitus. He discovered ancylostoma. Besides medicine, Ibn Sina made contributions to science,
mathematics, chemistry, and philosophy.
[i] The term European is used here to refer to a distinct culture and world-view based
on Greco-Roman and Judeo-Christian traditions. It developed in Europe and was carried by
European colonizers, settlers, and rulers all over the world. It is today the dominant culture on the world scene.
[xxix]latatabi’anna sunan alladhiina min
qablikum hadhwan al qatra bi al qatra hatta law dakhaluu juhra dhabbi ladakhaltumuuhu qaalu al yahuudi wa al nasaar ya rassula
al llaah? Qaala faman?.... Lata akhudha ummati bima akhadhat al umam qablaha shibran bi shibrin wa diraa’an bi dhiraa’in
hatta law minhum man ata umahu ‘alaniyyatan lakaana min ummati man ya ati ummahu ‘alaniyyatan. …. ‘an
abi sa’ied al khudhri : latatabi’anna sunan man kaana qablakum shibran bi shibrin wa dhiraa’anbi dhiraa’in hatta law salakuu juhra dhabbin lasalaktumuuhu. Qulna ya rasuul al llaah al yahuud wa
al nasaara? Qaala faman?