ISLAMIC PHILOSOPHY OF MEDICINE

By Amanullah Khan, M.D., Ph,D.

"Nor walk on the earth with insolence; for thou canst greatly encouraged. The learned were patronized not rend the earth asunder. nor reach the mountains in and given every facility for propagating knowledge. height." XVII:37 Most of them were Christians or Jews at that time. The learning center and Jundeshapur became fervent The belief is a very strong component of our with activity during the period of Abbasids. It served religion. Islam itself means submission to the will of as a melting pot for Nestorian physicians, Greek Allah. The religion places tremendous responsibility physicians who were leaving Athens, and physicians on the individual. It is the individual himself or herself arriving from India and Syria. It became a large (hat is answerable for all his or her deed and no one medical center. People were sent long distances in else will help on the day of judgement. search of remedies and medical knowledge. Many Greek works were translated into Arabic. "Namely, that no bearer of burdens can bear the burden of another:" PERIOD OF TRANSLAnON AND AMALGAMA­ "That man can have nothing but what he strives TION: jar; " Greek medical works, especially those of Galen were "Thor (the fruit oj) his striving Will soon come in translated during the early 9th century by a prolific sif.{ht:" translator Humayn ibn Ishaq and his disciples in "Then will he be rewarded with a reward Bagdad, which became one of the great learning complete. " LlIl:38-41 centers afthat period. He translated voluminous materials and many of these manl,lscripts can still be Thus. the principals laid down by Islam attempted found in th libraries of Constantinople. He aLso wrote to purge the society of tribal traditions and ills and manuals and textbooks for students, such as helped crealI.' a healthy society. "Question on Medicine" (which was in the question and answer form), "Ten tratises on the Eye" (the first MlJSLlM QUEST FOR KNOWLEDGE AND text book of opthalmology) and numerous other HARMONY AMONG RELIGIONS: similar works. Hunayn demonstrated that he was an This is mostly a discussion of the philosophy of excellent editor because his writings were very Islam as it affected science in general and medicine in succinct, and translated from at least three different particular. As Islam spread rapidly during the 7th and manuscripts of a book so as to maintain and preserve 8th centuries, Muslims came in contact with the older the original thought. Compandiums of medical civilil.ations. During this period of interaction, the knowledge were compiled discussing various diseases Muslim philosophy provided a perfect stage for the systematically. This provides evidence of the retrieval and preservation of olden literary treasures. understanding of medicine even in those early days. There was tremendous emphasis on acquiring knowledge. The Arabic language served as flexible Hygiene was emphasized medium for translation of these works. Great literary Diseases ofsystems starting from the head, centers developed e;.;tending from India to Eastern er/ding at the feet Europe, as the Byzantine and Persian Empires were InfectiOUS diseases anneJdisease was discussed clearlY giving tbe

Page 26 - The Journal of fMA - August 1978 I I '- etiology, signs and symptoms and the treatment. Physicians would travel long distances, stopping to discuss medical problems and their skills on the way to THE ERA OF NEW KNOWLEDGE, the pilgrimage, thus disseminating their own Following this initial period of amalgamation and knowledge and acquring new skills. translation of Greek, Persian, and Indian medicine, a EMPHASIS ON PREVENTIVE MEDICINE: great upsurge in new thought was seen during the 9th The philosophy of Islam in itself contributed to and 10th centuries. I would like to quote the example better hygiene and principals of preventive medicine. of al Razi -- also known as Rhazes. He was a Persian For example, I would like to quote from Hadith (The Muslim who trained under Hunayn ibn Ishaq, He Actions and Sayings of Prophet Mohammad and his must be regarded as one of the greatest physicians of Companions). all times, who produced over 100 medical writings. One of the most comprehensive books on medicine "If you hear about plague in a land, don't go to it, was written by al Razi and entitled al·Hawi. It but if you were in that land, don't run away." "No son of Adam would fill a container worse than consisted of 20 volumes. The diseases were described his stomach." clearly drawing on the experience of Greek, Arabic, Syrian, Persian, and Indian physicians and he "The stomach is the home of illness and dieting the head of all treatment." concluded by adding his own observations and experience. his work on small pox and measles was Cleanliness was also emphasized a great deal. Qur'an translated for centuries to come in other languages. emphasized cleanliness also: The breadth of his wisdom and the scope of his understanding of the humanistic and ethical problems .'A ndthy garments keep free from stain. "LXX/VA faced by the physician can be seen be merely looking at "0, ye who believe when ye prepare for prayer, some of the titles of his works. wash your faces and your hands to the elbows, rub your heads (with water) and wash your feet /0 the ankles." V:7 "Why People Prefer Quacks and Charlatans 10 Skilled Physicians'?" Qur'an again emphasizes purity of food that you "Why Ignorant Physicians. Layman, and Women consume: have more Success than Learned Medical Men?" "On the fact that evell SkiJIed physicians Cannot "This day or (on) things, good and pure made Heal Aff Diseases?" lawful unto you. The food ofthe people oj the Book is lawful unto you and yours is lawful unto them. ,. These titles also suggest that inspite of vast V:6 understanding of medicine as practiced at that time, he Again from Qur'an: was well aware of the shortcomings as a physician. "Forbidden to you (jar food) are: dead meat, blood, theflesh ofswine, alld thaI on which halh been This period saw numerous other physicians, both in invoked the name ofother thall God,' That which hath the Eastern and Western Islamic empire. One of the been kilfed by stcmgling, or by a violent blow, or by a well known names of that period is Abu Ali aI-Husayn headlong fall, or by being gored to death; that which ibn Sina also know as Avicenna. One of his well hath been (partly) eaten by a wild animal; unless ye are known books is the Canon of Medicine. This was an able ro slaughter it (in due form); That which is excellent encyclopedic work. I could mention sacrificed on stone (altars); (Forbidden) also is the numerous works by Muslim physicians establishing the division (oj meat) by raffling whith arrows; that is influence of the Islamic period which molded the impiety. " VA shape and future of medicine. These works were read, translated, and reprinted for many centuries to The use of variom intoxicant was prohibited. Qur'an come. Hospitals and medical academies were created refers to this as follows: throughout the Islamic world. These also served as "0, ye who believe intoxicanls and gambling teaching centers for medical students, where learned (dedication of) stOnes and (divination by) arrows are physicians taught medical science. Most of the an abomination of Satan's handiwork; Eschew such training was in the form of apprenticeship with (abnmination), that ye mayprosper. ., V:93 experienced physicians. There was also a system of granting diplomas and inspecting the skill of ISLAMIC PHILOSOPHY AND MEDICAL ETHICS physicians, pharmacists, barbers, and orthopedic One of the honest issues in medicine, these days, is surgeon. The annual pilgrimage to Mecca also served the subject of medical ethics, morality, and liability. as a factor in dissemination of medical knowledge. ~f one looks back, it becomes apparent that Hadith

The Journal of IMA - August 1978 - Page 27 refers to these problems. It will also be of interest to 3. What the Physician Must Avoid and Beware of note that problems faced by the physicians and the 4. Directions of the Physician to the Patient and patients today, are not any different from the Servant problems faced at that time. I would like to quote 5. Manners of the Visitors hadith on the responsibility of the physicians. 6. Care of Remedies by the Physician "A person whoever practice treatment when he was 7. What the Physician Asks the Patienl and the Nurse not known to be acquainted with medicine before, will 8. What the Patient May Conceal from the Physician he re~ponsibile". 9. How the Healthy and III Must Takc Orders of the Another Hadith delineates when a patient should seek Physician treatment: 10. Training of Servants by the Patient before Illness "You servants of Allah, seek treatment, for Allah 11. Patient and Visitors didn't :>end down an illness that Allah 'didn't send 12. Dignity of the Medical Profession down treatment for it." 13. Respect for the Physician 14. Physicians and Peculiar Incider,!!s to Aid Hadith also made treatment mandatory or Treatment obligatory when a treatment was defintely available 15. Medical Art for Moral People and also if holding off this treatment would be 16. Examination of Physicians harmful. However, if one is not assured of benefits 17. Removal of Corruption of Physicians from a treatment and harm could occur, then it is IR. Warning against Quacks discouraged. These principals were designed to 19. Harmful Hahits discourage quackery apd protect the patient. 20. Care of the Physician Himself Onc of the most extensive works dealing with ethics was written by Ishaq ibn Ali al·Ruhawi. He was a Adab al-Tabib is a beautiful i1tustrtion of the fact Christian who embraced Islam and had also written that problems of responsibility, ethical dilemmas, and works on Galen. It will not be possible to cover all needs of Ihe so<.:eity are nothing new to medicine. A facets of his writings. His book. Adab al-Tabib review of Ihis work brings home the realization that (Ethic~ of a Physician) is an extensive work which the present day physician may have been derelict in his cannot be discussed at length due to constraints of responsiblity towrads the current ethical needs. In the time. It consisted of 112 folios with 17 lines per page. past, it was the physician who was the advocate of This was found in Suleymaniye Kitabhane. English morality, who defended ethics, and who was in the translation of which appears in the The Transactions forefront in delineating these areas, During the rC\:cnl of the Amedcan Philosophical Society, Vol. 57, part years, due to a variety of reasons, such as busy life, 3,1967, Philadelphia. The Islamic philosophy served narrow approach or lack of emphasis on ethics during as a basis for defining and suggesting solutions of the his medical training, he has failed to emerge as a ethical and moral problems facing physicians. The stalwart among the defenders of ethics and morality. translator of this work, Martin Levy, in his preface The definition of ethics and morality in medicine says, and I quote: has lately bC\:ome a favorite topic for politidans and "In addition, the contents of this world are non-physician bureaucrats who lack the insight into remarkable in their delineation of the manner in which the whole garnet of patient-physician relationship. It Muslim (and to lesser extent, Christians) religious is time that the physician got back into the saddle and ideas were made to harmonize with the older science he is still in a great position to do so. He is still and ethics of the Greeks in particular." regarded very highly and trusted by the people as The Islamic philosophy and the Muslim code was so shown by the polls. Unless the physician takes proper realistic and practical, that al-Ruhawj was at ease in steps, the public trust is likely to wither away. Every dealing with this difficult subject. The society was leaching physician needs to realize his duty -~ to train changing from a tribal primative society to a more the budding physicians, not only in the an of orderly .~ociety with emphasis on human values and medicine, but also in handling the ethical dilemmas of strong religious feelings. These were times of great medical practice, changes. Therefore, the setting for this work was not any different from the one prevailing at present. It In thc present day controversies of medical ethics, may be worthwhile just to glance at the titles of the 20 certain other aspects of the responsibilities of the other chapters of Adab al-Tabib. panies involved, which have been well delineated by I. Loyalty and Faith of the Physician, and Ethics he Ruhawi, have been completely ignored in the recent Must Follow to improve His Soul and Morals. years, For examp_le, the responsibilities of the patient 2. Care of the Physician's Body (Continued un Page - 31)

Page 28 - The Journal of IMA - August /978 black slaves were the most important personalities of Islam admits therefore, a social order which ensures Moslem society. Thus Zaid Ibn Harris was the the democratic principles of freedom ard equality. it Prophet's slave, whom he set free and in order to give does nOl sacrifice liberty for equality as communism the same treatment as to Arabs, he married him to his does. Islam complements one by means ofthe olher. cousin. Likewise, Islam does not admit of any privilege It gives man the freedom which allows him to evolve in social and economic life of one person over another. spiritually. so that he may enjoy life and be able to Historic examples taken at the time when Islamic law achieve in this world. It allows man to have his family, was applied according to Koranic texts give evidence to hi~ private property and social, and economic activities il. At the time of Khalif Ali, whose brother had many without encroaching upon the rights and equality of children, his salary did not suffice for the needs of the othcr~. family. He asked his brother. Khalif Ali, for an Continued from "Significance ofthe Tradition of the increase of salary so that he might live decently. But Prophet Mohammad {pbuh}" KnaUf Ali refused his brother's request, for he use their right hand may be of some significance. considered his brother's claim for an increase not although the dominance of the hemisphere is justified and that it might by the origin of a priviliege genetically determined. Further. lying on the right and social inequality. Islam makes no distinction side, while asleep, has other physiological effects wuch between black and white people. The Koran puts all as emptying of the spleen. massaging effect of the the nations on the same equal footing and it considers diaphragm on the liver, thereby improving the hepatic man as a human being and tries to uproot Arab circulation and emptying of the gastric content. chauvinism. It treats Arabs and non-Arabs in the Placing the right hand under the right side of the face same way. The Prophet Mohammed always makes certain that the hcad is comfortable and proclaimed human equality in order to dispel from squarely on the lateral side without rotation of the Arab minds all the prejudice of color. class and race cervical spine. This physiological position of the which had been deeply rooted for centuries in Arab cervical spine on the remainder of the spinal column mores and customs. Thus. the right to freedom, the has also a protective effect on the vertebral arteries right of equality, the rignt of property and its use, the which othrwise may become kinked and predisposed right to have a family are considered natural human to trauma. In this position. the remainder of the spine rights thai men possess unconditionally and without is also subjectd to less strain in terms of rotation of the exception. Man has these rights until the end of his vertebrae. thereby lessening the chances of life. osteroarthritis. Communism contrary to Islam denies totally individual freedom and henl;e, the property and all These are but a few of the examples and we are sure economic activities of the individual. It is only that we will find all of the traditions of the Prophet concerned with the interest of the society and sacrifices (peace be upon him), with this significance, some of all individual interest for the sake of "society". It is which may become understandable to us with the only concerned with individual interests in so far as passage of time. After all, the 1400 years-old tradition they contribute to the general interest. Islam, on the is not really old but ra,ther for all time, for all nations contrary, is COncerned with the individual interests as and for all people. wen as the general interest of the society. It tries to Continued from "Islamic Philosophy and Medicine" cono;;iliatc and balance one by means of the other. The and the society towards a physician. The patient has Marxist communism sacrifices freedom which is a equal respon~bility in the relationship between the natural right of the individual. Islam respects the physician and the patient. Similarly, the society has to individual liberty as part of man's dignity as well as ail realize the nature of demands placed on a physician the rights incumbent 10 it such as private property, and afford him the support that he may need at times. family and all economic activity. On the other hand. Islam differs from Adam Smith's doctrine of "Laissez faire-Iaissez passer" giving rise ro capitalism with all of its injustices and inequaHtLes of social conditions as Early thought has a parallel action. Every a result of the abusc by the rich class. prayer has a sound and a physical form. If we want to compare the Islamic economic system [Ruml] to Western economic system, one can conclude that the Islamic economic system is somewhat akin to There are a thousand forms of mind if the Western socialism which reconciles the individual seawater did not rise into the sky, were would interests with the interest of society. the garden gets Its life? [Rumi]

The Journal of IMA ~ August /978 - Page 3/