HEALING AND MEDICINE: HEALING AND MEDICINE IN ISLAMIC TEXTS AND TRADITIONS

In Islamic theology, God created nature, which functions in harmony and unity according to natural law. God also created human beings, who must submit to both God's law and natural law in order to function in harmony and unity in the universe. Therefore human beings are above animals because they alone can worship God and can redeem themselves through piety and good works. When harmony is disturbed by immoral or unhealthy behavior, a virus or microbe, an accident, or a personal or societal catastrophe, physical or mental disease may result. When a person's physical and mental functioning is impaired, he or she is considered sick and should seek treatment. In the Islamic worldview, good health is a sign of both a wholesome lifestyle and divine favor, and the healer or medical practitioner plays an important and highly valued role in the social order by restoring the physical or mental well-being of the patient. The physician must determine the malady and prescribe the remedy, which should be directed at the source, whether a microbe, injury, malnutrition, personal problem, societal disorder, or divine ill favor.

The Qurʾān contains many verses that pertain to health and healing and is considered the ultimate guide to good health. Verse 41:44 states, "Say: 'To the believers it [the Qurʾān] is a guidance, and a healing.'" Similarly, according to verse 10:57, "O men, now there has come to us an admonition [Qurʾanic revelation] from your Lord, and a healing for what is in the breast, and a guidance, and a mercy to the believers." Verse 26:80 quotes the words of Abraham and makes it clear that God is the ultimate curer of illness: "Lord of all Being who created me, and Himself guides me, and Himself gives me to eat and drink, and, whenever I am sick heals me, who makes me to die, then gives me life, and who I am eager shall forgive me my offence on the day of doom." The Qurʾān (2:219; 2:168; 2:180; 5:90) recommends a wholesome lifestyle, forbids intoxicants, and mercifully absolves the ill from fasting during Ramaḍān. Honey is one of many proofs of God's majesty and is the only remedy for ill health in the Qurʾān: "Then comes there forth out of (Bees') bellies a drink of diverse hues wherein is healing for men. Surely in that is a sign for a people who reflect" (16:72).

The ḥadīth, or sayings and doings of the Prophet collected and compiled after Muḥammad's death, offer extensive commentary on disease and medicine. In a much-quoted ḥadīth Muḥammad stated, "'God has not sent down a disease without sending down a remedy for it.' Bukhari transmitted it. Jabir reported God's messenger as saying, 'There is a medicine for every disease and when the medicine is applied to the disease it is cured by God's permission.' Muslim transmitted it." (Mishkāt al-maṣābīḥ, Vol. III, p. 945). Other well-known ḥadīth urge believers to seek treatment: "Usama b. Sharik told that when God's messenger was asked whether they should make use of medical treatment he replied, 'Yes, servants of God, make use of medical treatment, for God has not made a disease without appointing a remedy for it, with the exception of one disease, viz., old age.' Ahmad, Tirhidhi, and Abu Dawud transmitted it." (Mishkāt al-maṣābīḥ, Vol. III, p. 947.) According to Tirmidhi, "when God's messenger was asked whether [believers] should make use of medical treatment, he replied: 'Yes servants of God, make use of medical treatment for God has not made a disease without appointing a remedy for it, with the exception of one disease, namely old age'" (Mishkāt al-maṣābīḥ, Vol. III, p. 947).

Often, ḥadīth medical advice centers on the importance of cleanliness in food, drink, and personal hygiene. In some ḥadīth disease is a test, trial, or punishment to be dealt with patiently, and those who die from certain diseases or in childbirth may achieve martyrdom and heavenly reward. The Qurʾān explicitly rejects magic, but many ḥadīth recommend amulets or other talismans and charms to ward off disease. Belief in the evil eye as a cause of disease and other inflictions is common throughout and beyond the Muslim world.

Both Sunnī and Shīʿī texts stress the value of prayer in healing. In both traditions, Ṣūfī or mystical texts recommend healing through prayer and other devotional rituals. There are, however, substantial differences between Sunnī and Shīʿī ḥadīth. Shīʿī Islam values suffering and martyrdom far more than Sunnī Islam, so the Akhbārī (Shīʿī ḥadīth ) literature recommends that the patient suffer through the ailment and seek medical attention only in emergencies.

Greco-Islamic Medicine

When Muslims brought Islam to the Byzantine and Sassadid (Iranian) regions, they sought knowledge from the peoples they encountered. The first translators were mostly Christians who translated works from Greek into Syriac and then into Arabic. Persian and Indian medical texts were also translated into Arabic. The formal tradition of Islamic medicine was based on Galen's (129–c. 199 ce) descriptions of elements and humors. The basic elements were earth, fire, air, and water. Each element had a temperament: earth was dry and cold, fire was dry and hot, air was humid and hot, and water was humid and cold. The temperaments corresponded to the humors of the body: blood, phlegm, yellow bile, and black bile. When the humors were in balance, the body was healthy. When the humors were out of balance, the result was disease, which the physician or patient could treat through appropriate food or drink, drugs, or temperature adjustment. Islamic physicians generally distinguished between the body and the spirit or soul (rūḥ ), and they believed God worked through the rūḥ to cure the patient. The physician was to take care to address the state of the patient's rūḥ in determining a treatment. While some of the physicians denounced it, astrological medicine was much practiced. Many medical texts had sections on astrological influences on disease causation, and most astrological manuals had sections giving medical advice.

By the ninth century, Muslim physicians were synthesizing and adding to the Greek, Persian, and Indian medical traditions, and healthcare was becoming a major institution. Caliph Hārūn al-Rashīd (d. 809 ce) built the first bimaristan (hospital) in Baghdad along the lines of the famous medical institution at Jundishapur. It was soon followed by other hospitals with physiologists, oculists, surgeons, and bonesetters on their staffs. In Cairo the Mamlūk ruler Mansur Qalawun (d. 1290) built the Mansuri Hospital in 1284–1285. The hospital complex had a substantial religious endowment (waqf) and served thousands of patients. According to the founding waqf document:

The [hospital] is for kings or subjects, old or young, free or slave, male or female. Upon recovery patients shall receive clothing while the deceased shall receive burial shrouds and all funeral expenses will be paid. Funds are allocated for herbalists, surgeons, bonesetters, ophthalmologists, and general practitioners, and for all patients, whether male or female, and their caregivers. Funds are available for beds, bedding, patient hygiene, and general sanitation.… Funds are also available for outpatients for food and medicine. (Isa, pp. 86–88)

The Mansuri Hospital had rooms for specialized cases including fevers, eye diseases, and wounds, and a separate wing for women. It contained a kitchen, a dispensary, a laboratory for medicine, a library, and an auditorium where the chief physician lectured his students. The mosque and madrasah (school) that formed part of the complex still stand though the hospital building was replaced in 1920. It was used as an ophthalmic clinic until the 1992 earthquake damaged it. The complex is currently undergoing extensive restoration.

Only a few of the renowned physicians can be mentioned here in order to demonstrate their contributions to the received medical tradition. Abū Muḥammad al-Rāzī (Rhazes; d. 930 ce) was born in Rayy near Tehran but worked mostly in Baghdad. He was the first to describe the clinical symptoms of smallpox as distinguished from measles. He also wrote cheerful essays, such as "Why Ignorant Physicians, Common Folk, and Women in the Cities Are More Successful Than Scientists in Treating Certain Diseases—and the Physician's Excuse for This."

ʿAli ibn al-ʾAbbas al-Majusi, or Haly Abbas (d. 994 ce), the director of the Adud-dawlah Hospital in Baghdad, compiled the Kitāb Kamil al-Sina al-Tibbiyya (The complete book of the medical art), also known as al-Kitāb al-Malikiʾ (The royal book). This famous text has one volume on theoretical medicine and another on practical medicine and is a concise and well-organized summary of Greco-Islamic medical knowledge.

Abū ʿAlī Ibn Sīnā or Avicenna (980–1037) identified diseases such as meningitis and discovered new remedies, but his greatest contribution was his system of medicine, in which medical practice was combined with physical and psychological factors, drugs, and diets—or "holistic" medicine. His Canon of Medicine was translated into Latin and was used more than Hippocrates and Galen in Europe.

Abū ʿAli al-Hasan ibn al-Haytham (Alhazen; d. 1040) worked mostly in Cairo. He is known for his seven-volume treatise on optics, Kitāb al-Manazir, which built on Ptolemy's theories but demonstrated through experimental evidence that in vision light is reflected from an object into the eye, thus reversing the received theory.

Ibn Nafis (d. 1288) studied medicine in Damascus and became director of the Mansuri Hospital in Cairo. His Mujiz, a widely used commentary on Ibn Sīnā's Canon, contains his famous theory of the pulmonary or lesser circulation of the blood, which was subsequently proved correct.

Customary Medicine

Customary, or empirical, medicine was probably the most widely used type of medical intervention in everyday life. ʿAbd al-Raḥmān ibn Khaldūn (1332–1406), the famous historian and sociologist, carefully distinguished between empirical medicine, Greco-Islamic or humoral medicine, and religious doctrine:

Civilized Bedouins have a kind of medicine that is mainly based upon individual experience. They inherit its use from the shaykhs and old women of the tribe. Some of it may occasionally be correct. However, it is not based upon any natural norm or upon any conformity [of the treatment] to the temper of the humors. Much of this sort of medicine existed among the Arabs. The medicine mentioned in religious tradition is of the Bedouin type. It is in no way part of the divine revelation. [Such medical matters] were merely part of Arab custom and happened to be mentioned in connection with the circumstances of the Prophet, like other things that were customary in his generation. They were not mentioned in order to imply that that particular way of practicing medicine is stipulated by the religious law. Muḥammad was sent to teach us the religious law. He was not sent to teach us medicine or any other ordinary matter. None of the statements concerning medicine that occur in sound traditions should be considered as [having the force] of law. The only thing is that if that type of medicine is used for the sake of a divine blessing and in true religious faith, it may be very useful. However, that would have nothing to do with humoral medicine but be the result of true faith. (Ibn Khaldūn, p. 387)

For Ibn Khaldūn, the humoral medicine of the Greco-Islamic tradition was scientific and therefore valid; faith, if sincere, might be helpful; and empirical medicine might be useful in a haphazard way.

Prophetic Medicine

Prophetic medicine (tibb al-nabawi ) developed alongside the formal medical tradition. The authors of prophetic medicine were generally not practicing physicians or scientists but rather ʿulamāʾ (specialists of Islamic theological and legal sciences) who worked out "religiously correct" compendiums of medical lore that blended empirical medicine, religious formulas, and sometimes Greco-Islamic ideas. Prophetic medical texts typically list both physical and spiritual diseases (fevers, leprosy, plague, poisonous insect and snake bites, melancholy) and offer remedies drawn from the Qurʾān and ḥadīth. Muḥammad b. Aḥmad al-Dhahabī (d. 1348) cites several major Greek and Islamic medical authorities, empirical medicine, and the Qurʾān and ḥadīth as his sources. Jalāl al-Dīn al-Suyūṭī (d. 1505), however, based his prophetic medical book on what was known of the medicine of the Arabian Peninsula, the Qurʾān, and the ḥadīth but not the Greco-Islamic tradition. Suyūṭī recommended prayers and invocations, amulets and talismans, but did not mention surgery. Much of his medical advice was preventive and recommended moderate habits and the avoidance of intoxicants. Perhaps the most famous of the prophetic medical compendiums, Medicine of the Prophet (1998) by Abū Bakr ibn Qayyim al-Jawzīya (1292–1350), has been published in English translation. Its medical advice relies more on piety than on Greco-Islamic medical theory and contains much information on medical beliefs and practices of ordinary people in the fourteenth century.

Modern Medicine

Muslim physicians did not hesitate to borrow from European physicians, particularly for unfamiliar diseases. Dāwūd ibn Umar al-Antaki (d. 1599) includes the standard mercury treatment for syphilis used in Europe at the time. Syphilis was unknown in North African and the Middle East until the late fifteenth century or early sixteenth century. Ottoman physicians began translating selected medical works from European languages in the early nineteenth century. During that century cholera spread from India, where it was endemic, via long-distance transportation to port cities and elsewhere in the Muslim world. In 1831 Mustafa Behcet (d. 1833), head of the medical college in Istanbul, published a treatise on cholera based on an Austrian source that Ottoman authorities distributed free throughout the empire. Ottoman authorities established a quarantine service in about 1832 and had religious leaders publish treatises showing that quarantines were not contrary to Islamic law.

Today Western medicine is well established throughout the Muslim world. In several South Asian nations it is possible to study and be certified in Greco-Islamic medicine. Institutes in Cairo and elsewhere study remedies recommended in the ḥadīth, such as "black seed," to determine their efficaciousness in treating various diseases. Inexpensive compendiums of prophetic medicine can be purchased in bookshops throughout the region and may be consulted for informal or alternate treatments. Those with serious illnesses and adequate resources, however, generally prefer to consult reputable specialists trained in the Western medical tradition.

Bibliography

Arberry, Arthur J. The Koran Interpreted. New York, 1955. An authoritative translation of the Qurʾān.

Avicenna. A Treatise on the Canon of Medicine of Avicenna, Incorporating a Translation of the First Book, by O. Cameron Gruner. London, 1930.

Avicenna. Canon of Medicine. Chicago, 1999. An English translation of the classic text.

Elgood, Cyril. A Medical History of Persia and the Eastern Caliphate from the Earliest Times to the Year ad 1932. Cambridge, U.K., 1951.

Gallagher, Nancy. Medicine and Power in Tunisia, 1780–1900. New York, 1983. A study of the transition from traditional Islamic to Western medicine.

Ibn Khaldūn. The Muqaddimah: An Introduction to History. Translated by Franz Rosenthal, edited and abridged by N. J. Dawood. Princeton, N.J., 1969.

Ibn Qayyim Al-Jawziyya. Medicine of the Prophet. Translated by Penelope Johnstone. Cambridge, U.K., 1998. An informative and readable example of the prophetic medical tradition.

Isa, Ahmad. Taʿrikh al-bimaristanat fi al-ʿIslam. Damascus, 1939.

Mishkāt al-Maṣābīḥ, translated by James Robson. Vol. III, Lahore, 1964.

Morsy, Soheir. Gender, Sickness, and Healing in Rural Egypt. Boulder, Colo., 1993. An anthropological analysis of medical practices in contemporary rural Egypt.

Rahman, Fazlur. Health and Medicine in the Islamic Tradition. New York, 1987. An analysis of traditional and modern medical practices and ethics by a noted Muslim philosopher.

Ullmann, Manfred. Islamic Medicine. Edinburgh, 1978. A reliable survey.

Nancy Gallagher (2005)