Islamic Philosophy of Medicine*

AmanulJah Khan, M.D., Ph.D. DaJlas, Texas

DOI: http://dx.doi.org/10.5915/20-1-13049

In this paper, I shall discuss the philosophy of "Questions on Medicine" (which was in the question Islam as ii affected science in general and medicine in and answer form), "Ten treatises on the Eye" (the particular. As Islam spread rapidly during the 7th first text book of opthalmology) and numerous other and 8th centuries, Muslims came in contact with the similar works. Hunayn demonstrated that he was an older civilizations. During this period of interaction, excellent editor.' His writings were very succint, and the Muslim philosophy provided a perfect stage for translated from at least three different manuscripts the retrieval and preservation of older literary of a book so as to maintain and preserve the original treasures. There was tremendous emphasis on acquir­ thought. Compendiums of medicaJ knowledge were ing knowledge. The Arabic language served as a flex­ compiled discussing various diseases systematically. ible medium for translation of these works. Great This provides evidence of the understanding of literary centers developed, extending from lndia to medicine even in those early days. Eastern Europe, as the Byzantine and Persian Em­ Hygiene was emphasized. Diseases of systems pires were annexed to lhe Muslim world and Greek starting from the head, ending at the feet, infectious medicine was way past its epoch. The school at diseases, toxicology, fractures, nutrition, and sex Jundeshapur, after Islam reached the Persian em­ were all dealt with. pire, was not only left untouched but che learning at Each disease was discussed clearly giving the this institution was greatly encouraged. The learned etiology, symptoms and signs, as well as the treat­ were patronized and given every facility for pro­ ment. pagating knowledge. Most of them were Christians or Jews at that time. The learning center at 2. The era of new knowledge: Jundeshapur became fervent with activity during the A great upsurge in new thought was seen during period of Abbasids. It served as a melting pot for the 9th and 10th centuries. r would like to quote the Nestorian physicians, Greek physicians who were example of al-Razf, also known as Rhazes. He was a leaving Athens, and physicians arriving from India Persian muslim who trained under l:lunayn ibn and Syria. It became a large medical center. People l s~aq. He must be regarded as one of the greatest were sent long distances in search of remedies and physicians of all times, who produced over 100 medical knowledge. Many Greek works were medical writings. One of the most comprehensive translated into Arabic. Islamic medicine developed books on medicine was written by Al-Razl and entitl­ through rwo successive stages. ed "al-I:Jawi. "' It consisted of 20 volumes. The diseases were described clearly drawing on the ex­ 1. Period of translation and amalgamation: perience of Greek, Arabic, Syrian, Persian, and In­ Greek medical works, especially those of Galen dian physicians and he concluded by adding his own were translated during the early 9th century by a pro­ observations and experience. His work on smallpox Ii fic translator, l:;:lunayn-ibn-Is~aq and his disciples in and measles was tanslated, for centuries to come, in Bagdad, which became one of the greatest learning other languages. The breadth of his wisdom and the centers of that period. He translated voluminous scope of his understanding of the humanistic and materials and many of these manuscripts can still be ethical problems faced by the physician can be seen found in the libr.aries of Constantinople. He also by merely looking at some of the titles of his works: wrote manuals and textbooks for students, such as ''Why People Prefer Qua ks and Charlatans to Skill­ ed Physicians?" "Why Ignorant Physicians, Laymen, and Women Have More Success Than Learned Medical Men?" Author's Address: Wadlely Institute of Molecular "On the Fact That Even Skilled Physicians Cannot Medicine, 9000 Harry Hines Street, Dallas, Texas. Heal All Diseases?" These titles also suggest that inspite of his vast *Original article appeared in J IMA 1978; 9:26-28 understanding of medicine as practiced at that time,

Page 8 - JIMA: Volume 20, 1988 he was well aware of the shortcomings of a physician. a headlong fall, or by being gored to death; that Thjs period saw numerous other physicians, both which hath been (partly) eaten by a wild animal: in the Eastern and Western Islamic empire. One of unless ye are able to slaughter it (in due form); That Lhe well known names of that period is Abu 'Alf al­ which is sacrificed on stone (altars); (Forbidden) also Husfn ibn Sina also known as Avicenna. One of his is lhe division (of meat) by raffling with arrows; that well known books is the "Canon of Medicine. m This is impiety.'" was an excellent encyclopedic work. I could mention numerous works by Muslim physicians establishing "O, you who believe, intoxicants and gambling, the influence of the Islamic period which molded the (dedication of) stones, and (divination by) arrows are shape and future of medicine. These works were an abomination of Satan's handiwork; Eschew such read, translated, and reprinted for many centuries to (abomination), that ye may prosper." 10 come. Hospitals and medical academies were created Islamic philosophy and medical ethics throughout the Islamic world. These also served as One of the hottest issues in medicine today, is the teaching centers for medical students, whereJearned subject of medical ethics, morality, and liability. If physicians taught medical science. Most of the train­ one looks back, it becomes apparent that Hadith ing was in form of apprenticeship with experienced refers to these problems. It will also be of interest to physicians. There was also a system of granting note that problems faced by the physicians and the diplomas and inspecting the skill of physicians, phar­ patients today, are no different from the problems macists, barbers, and orthopedic surgeons. The an­ faced at that time. l would like to quote a certain nual pilgrimage to Mecca also served as a factor in I;Iadith that relates to the responsibility of physi­ dissemination of medical knowledge. Physicians cians: would travel long distances, stopping to discuss "A person whoever practices treatment when be was medical problems and their skiJls on the way to the not known to be acquainted with medicine before, p.ilgrimage, thus disseminating their own knowledge will be responsible." 11 and acquiring new skills. Another Hadlth delineates when a patient should Islamic philosophy and emphasis on preventive seek treatment: medicine: The philosophy of Islam in itself contributed to the "You servants of Allah, seek treatment, for Allah development of hygiene and principals of preventive did not not send down an illness that Allah did not 2 medicine. Examples of direct guidance by Prophet send down treatment for, except senility" 1 Mu~ammad (PBUH) are " lf you hear about plague in a land, do not go to it, l;Iadlth also made treatment mandatory or but if you were in that land, do not run away."> obligatory when a treatment was definitely available " No son of Adam would fill a container worse than and also if holding off this treatment would be harm­ his stomach.',. ful. However, if one is not assured of benefits from "The stomach is the home of illness and dieting the treatment and harm could occur, then it is discourag­ bead of all treatment."' ed. These principles were designed to discourage Cleanliness was also emphasized a great deal in the quackery and protect the patient. Qur'an. Allah says: One of the most extensive works dealing with ethfos was written by I s~aq ibn 'All al-Rii~awi. He "And thy garments keep free from stain.''6 was a Christian who embraced Islam and had also "O, ye who believe when ye prepare for prayer, wash written works on Galen. It wiJI not be possible to your faces and your hands to the elbows, rub your cover all works on Galen, or to cover all facets of his heads (with water) and wash your feet to the writings. His book, Adab al-Tablb (Ethics of a ankles. " 1 Physician) is an extensive work· which will be only The Qur'an emphasizes the purity of food that one briefly discussed. Jt consisted of 112 folios with 17 consumes: lines per page and was found in Sulimaniyah Kitabkhanah, a ljbrary in Turkey. It has been "This day all things, good and pure are made lawful translated into English. ' 3 The Islamic philosophy unto you."' served as a basis for defining and suggesting solu­ tions of the ethical and moral problems facing physi­ "Forbidden to you (for food) are: dead meal, blood, cians. The translator of this work, Martin Levy, in the flesh of swine, and that on which hath been in­ his preface states " ... ln addition, the contents of voked the name of other than Allah; That which hatb this work are remarkable in their delineation of the been killed by strangling, or by a violent blow, or by manner in which Muslim (and to lesser extent, Chris-

JIMA: Volume 20, 1988 - Page 9 tian) religious ideas were made to harmonize with the is time that physicians got back into the saddle as older science and ethics of the Greeks in they are still in a great position to do so. Physicians particular." ' J are still regarded very highly and trusted by the peo­ The Islamic philosophy and the Muslim code were ple as shown by the polls. Unless physicians take pro­ so realistic and practical, that al-Ru~awi was at ease per steps, the public trust is likely to wither away. in dealing with this difficult subject. Every teaching physician needs to realize his duty to The society was changing from a tribal primitive train the budding physicians, not only in the art of society to a more orderly society with emphasis on medicine, but also in handling the ethical dilemmas human values and strong religious feelings. These of medical practice. were times of great changes. Therefore, the setting In the present day controversies of medical ethics, for this work was no different from the one prevail­ certain other aspects of the responsibilites of the ing at present. It is worthwhile to examine the titles other parties involved, which have been well of the 20 chapters of Adab al-Tabib: delineated by al- Ruhawi, have been completely ig­ nored in the recent years. For example, the respon­ I. Loyalty and faith of the physician, and ethics he sibilities of the patient and the society towards a must follow to improve his soul and morals physician. The patient has equal responsibility in the 2. Care of the physician's body relationship between the physician and the patient. 3. What the physician must avoid and beware of Similarly, the society has to realize the nature of 4. Direc;tions of the physician to the patient and ser- demands placed on a physician and afford him the vant support that he may need at times. 5. Manners of the visitors 6. Care of remedies by the physician 7. What the physician asks the patient and the nurse References 8. What the patient may conceal from the physician 1. AJ-Razi (Rhazes - 841-944 AD) "al-J:lawi" 9. How the healthy and ill must take orders of the 2. Ibn Sina (Avicenna - 980-1037 AD) "al-Qanun physician rl'Hibb" (Cannon of Medicine) 10. Training of servants by the patient before illness 3. SaI:iil:i al-Bukhari - Division 71, Book of 11. Patient and visitors Medicine, Chapter 30, vol 7, p 418, number 624. 12. Diginity of tbe medical profession English translation by M.M. Khan, Dar al 13. Respect for the physician 'Arabiah, Publishing, Printing and Distribution, 14. Physicians and peculiar incidents to aid treat- Beirut, Lebanon. ment 4. Sunan al-TirmidhT, Bab al-Zuhd, Chapter 47, 15. Medical art for moral people 'Abd al-Wahab 'Abd al-Latif, editor, al­ 16. Examination of physicians Maktabah al-Salaffiyah Medina, Saudi Arabia, 17. Removal of corruption of physicians Second edition, 1974. 18. Warning against quacks 5. Tbn Majah (Arabic), Book of Medicine, Chap1er 19. Harmful habits 3, Muhammad Fu'ad 'Abdul Baqi, editor, 'Isa 20. Care of the physician himself al-Babi al-J::ialabi Publishing Company, Cairo, Egypt. Adah al-Tabib is a beautiful illustration of the fact 6. Glorious Qur'an, Chapter 74, verse 4 that proble~s of responsibility, ethical dilemmas, 7. Glorious Qur'an, Chapter 5, verse 7 and needs of the society are nothing new to medicine. 8. Glorious Qur'an, Chapter 5, verse 6 A review of this work brings home the realization 9. Glorious Qur'an, Chapter 5, verse 4 that the present day physician may have been derelict 10. Glorious Qur'an, Chapter 5, verse 93 in his responsibility towards the current ethical 11. Sunan Abu Dawud (Arabic), Book of Diyyat, needs. In the past, it was the physician who was the Chapter 23, 'lzzat al-Da"as and 'Adil al-Sayyid, advocate of morality, who defended ethics, and who editors. Published by Muhammad 'Ali al-Sayyid, was in the forefront in delineating these areas. Dur­ Hims, Syria, 1972. · ing the recent years, due to a variety of reasons, such 12. fun Majah (Arabic), Book of Medicine, Chapter as busy life, narrow approach or lack of emphasis on 16, Muhammad Fu'ad 'Abdul Baqi, editor, ·Isa ethics during medical training, the physician has fail­ al-Babl ·al-J:Ialabi Publishing Company, Cairo, ed to emerge as a stalwart among the defenders of Egypt. ethics and morality. 13. Ts~aq ibn 'Ali al-RuQ.awi, Adah al-Tabib, The definition of ethics and morality in medicine English translation by Martin Levy, in "Transac­ has lalely become a favorite topic for politicians and tions of the American Philosophical Society" non-physician bureaucrats who lack the insight into Philadelphia, 1967, vol 57, part 3. the whole gamut of patient-physicin relationships. lt

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