Voices of Islam (217 page)

An imbalance in temperament can be either qualitative or material. If the imbalance is qualitative, it does not affect an organ directly. For example, a fever is a qualitative imbalance of temperament because it does not affect a particular organ of the body. A material imbalance directly invades an organ of the body and causes change. A cancerous tumor causes a material imbal- ance in temperament because it directly affects a particular part of the body. The Egyptian scholar Suyuti considered the temperament of the Prophet Muhammad to have been the most balanced of human temperaments. This was because his moral character and the temperament of his body were in perfect equilibrium. A tradition related from ‘A’isha, the wife of the Prophet, states, ‘‘His character is the Qur’an.’’ Since the Qur’an, as God’s revelation to humanity, is the embodiment of divine justice and truth, the Prophet’s temperament was also justly balanced because his character corresponded to God’s justice and truth. Conversely, if the Prophet’s temperament were the

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most balanced of temperaments, then his character must have been the best of characters as well.
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The Humors

Each of the four elements relates to a corresponding humor, substances that are made up of quasi-material or semi-gaseous vapors. The humor of blood (Sanguineous Humor) relates to air, so that it is hot and moist when balanced. The humor of phlegm (Serous Humor) relates to water, so that it is cold and moist when balanced. The humor of yellow bile (Bilious Humor) relates to fire, and is hot and dry when balanced. The humor of black bile (Atrabilious Humor) relates to earth, so that it is cold and dry when balanced. The four humors were first observed by the Greek physician Hippocrates,

who noticed four mixtures in the blood. The red portion of the blood he related to the humor of blood, the white material mixed with the blood he designated as the humor of phlegm, the yellow froth on top of the blood he called the yellow bile humor, and the black bile humor was related to the heavy part of the blood that settles to the bottom when the blood is precipitated. The four humors were later refined by Galen, who observed that all illness and disease were the result of an imbalance in the humors. The Muslim philosopher and physician Ibn Sina added two fluids to the humors as secondary humors: intracellular fluids and extracellular fluids. He further observed that the four primary humors arise out of the digestive process. He believed that the primary humors and the fluids were used as nutrients for the maintenance, growth, and repair of the organs, as well as for supplying the energy necessary to do work.

Existing as they do in a kinetic state, the humors are continuously adjust- ing and mixing with the body’s organs, fluids, and tissues. The preservation of the vital force or immune system of the body depends on the balance of the humors. Any treatment given for an imbalance in the humors is to help the body regain this ability. According to the theory of humors, the four humors arise in the liver, depending on the nature of the food that one eats and the degree of digestion that follows. The liver fi forms the blood humor (hot and moist) from the best of the nutrients in the food that has been eaten. Then the phlegm humor (cold and moist) arises as part of the next stage of the digestive process. In normal digestion, the phlegm humor changes into mucus, saliva, and gastric and intestinal mucus. If there is a problem at this stage because of the quality of the food ingested, excess mucus is formed, which is then classified as sweet, sour, thick, or thin.

The coarser and less refi products of the digestive process form the yellow bile humor (hot and dry). This humor is stored in the gall bladder, renders the blood subtle, and helps it pass through the narrow channels of the veins and arteries. Part of the yellow bile humor is carried to the bowels and produces the color of the feces. The sediment that is left over comes from

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the least digestible and least usable parts of the nutrients ingested; these materials form the black bile humor (cold and dry). When balanced, the black bile humor feeds the spleen and forms the bones. Part of the black bile humor passes to the opening of the stomach, where it creates stomach acidity and the hunger for food. This humor was considered the most toxic of the four humors and was thought to be responsible for cancerous growths in the body. When it is out of balance, the black bile humor passes out of the liver in the form of ash or it mixes with the other three humors and causes various morbid conditions.

The Fundamental Organs

The organs of primary importance are the brain, the heart, the liver, and the generative organs, the testicles or ovaries. The nerves serve the brain, the arteries serve the heart, the veins serve the liver, the spermatic vessels serve the testicles, and the fallopian tubes serve the ovaries. The vital power or innate heat of the body comes from the heart. Mental faculties and the powers of perception and movement are located in the brain, whereas the source of the nutritive and vegetative faculties is the liver. The generative organs, the testicles and ovaries, produce masculine and feminine genders and form the elements of reproduction.

The Souls

The psychological aspect of Islamic Medicine is based on the concept of two souls, or more accurately, one soul that is divided into secondary souls or functions. The first of these souls is the rational soul (
al-nafs al-‘aqliyya
), which governs the cognitive system and the ability to reason. The second is the animal soul (
al-nafs al-hayawaniyya
), which governs the instincts and passions, especially the attraction to pleasure and the instinct to repel harm or danger. This soul is called the animal soul because the instincts and pas- sions are shared by both human beings and animals. The goal of traditional psychology, or the ‘‘science of souls’’ (
‘ilm al-nufus
) in Islam, is to maintain a balance between these two souls.
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As in physical Islamic Medicine, the medicine of souls sees health as a state of equilibrium, in which the instincts, desires, and impulses that act on the human being are controlled and are in balance.

When the rational soul and the animal soul are in equilibrium, the emotions are balanced by reason. Simple imbalances occur because of a ‘‘quantitative’’ imbalance, in which certain aspects of the soul become too active or too passive, or they may occur because of a qualitative imbalance, in which one of the aspects of the soul is missing or not utilized. Compound imbalances result from the rational soul and the animal soul acting together in such a way that the passional aspects overcome the rational aspects.

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The desire for pleasure, a major aspect of the animal soul, is known as the ‘‘affective system.’’ It is the most basic aspect of the animal soul and is the fi st to develop in the human personality. Its purpose is to preserve the human species. This aspect of the animal soul comes into play when one yields to the infl ence of inner passions or outer stimuli. The virtue that restores a sense of balance to the passions and the desire for pleasure is temperance. Too much desire shows itself as greed; too little desire connotes a lack of self-esteem; a lack of emotional responsiveness or affect may indicate envy.

The avoidance of pain is another important aspect of the animal soul. This instinct (
ghariza
) forms the psychological basis of the ‘‘behavioral system.’’ Shared by both humans and animals, the instinct of pain avoidance exists in order to preserve the life of the individual. Because it is an instinct, it is pre- conscious, and thus capable of being disciplined, whereas the affective system that governs passion and desire is unconscious. The virtue that brings the ‘‘fight or flight’’ tendencies of this aspect of the soul into balance is courage. Too much courage shows itself as anger or recklessness and may lead to the love of power and ambition. Too little courage results in cowardice and imaginary fears or phobias.

When they are given too much free rein in the human personality, the affective and behavioral systems of the animal soul may corrupt the rational soul. This results in the loss of reason and the inability to rationally exercise free will; by themselves, these aspects of the animal soul do not utilize reason. As preconscious instincts or unconscious processes, they instead utilize inner impulses and the imagination to move the self toward seeking pleasure or avoiding harm. The psychic ‘‘motion’’ that they cause within the self is what we call emotion. The affective system seeks love and pleasure whereas the behavioral system avoids hate and pain. Both systems were thought to be located in the heart. However, the affective system receives its energy from the liver. This energy flows through the veins, causing the attraction to pleas- ure. The desire for pleasure is the most basic drive of human nature. Unlike the affective system, the behavioral system receives its energies from the heart through the arteries.

Reason (
‘aql
), the property of the rational soul, belongs to the human being alone. While the purpose of the affective system is to preserve the spe- cies and the purpose of the behavioral system is to preserve the individual, the purpose of the cognitive system is to preserve consciousness. Consciousness is defined as the exercise of free will and the development of a conscience with which to balance free will. Whereas the animal soul is instinctive and is fully formed at birth, the rational soul develops as one grows and matures. The nature of its quantitative and qualitative development depends upon the processes of nurturing and education. The highest virtue achieved by the rational soul is wisdom (
hikma
). Too little wisdom shows itself as igno- rance (
jahl
); the development of knowledge without wisdom leads to

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hypocrisy (
nifaq
). A lack of the qualitative function of the rational soul results in disbelief in God (
shirk
or
kufr
). The goal of Islamic psychology is the same as the goal of Islamic Medicine as a whole: to maintain balance, harmony, and equilibrium between the rational soul and the animal soul. The outward sign of inner balance is when a person manifests a sense of fairness and justice. Such a person is then referred to as being ‘‘centered.’’
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The Faculties and Energies

The faculties of the human body are the natural faculties, the vital faculties, and the nervous faculties. In Islamic Medicine, the human being is considered as a complete system that makes use of the energy transformed from food and air to satisfy its various natural dispositions. Energy moves from perception to motivation and motivation to perception. Motivation is the seat of impulses toward inclinations, which are imprinted on the external and internal senses. Then, through filtering into the practical intellect, a response is given. Three sources of energy are active in this perspective: natural or physical (venial) energy, vital (arterial) energy, and nervous energy. These transformed energies are distributed throughout the body.

Natural or Physical Energies
: The natural or physical energies are twofold. One, located in the liver, where the humors are also formed, is responsible for the preservation of the individual and therefore supplies energy for nutrition and growth. The other is located in the testicles and ovaries and is responsible for the sexual functions to preserve the human race. The nutritive function works through subordinate systems: retention, digestion, assimilation, and expulsion. The humors move by natural energy through the veins carrying sustenance to the body. A natural appetite, guided by nature in its mode of operation, instructs these various energies.

Vital Energy of the Heart
: Some natural energies and humors enter the cavity of the heart through transformation. There, they become vital energy, a substance that is less gross than the humors in the liver. The heart is the seat of life, of heat, of pulse, of the vital energies, and of nature in its mode of operation. It is the organ that lives first and dies last. Vital energies are carried to the organs of the body by arteries. They make life possible. They are transformed in the brain, where they become nervous energy. This makes perception and motivation possible.

Nervous Energy
: Nervous energy arises in the brain from the vital energy that reaches it from the heart. The brain, where the cognitive functions are located, is the center of motivation and perception. Motivation stimulates movement, and perception consists of the external and internal senses. In the cognitive system, vital energy from the heart is distributed to the nervous system, whereas the affective system receives natural energy through the veins and the behavioral system receives vital energy through the arteries.

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During the early stages of human development, before the cognitive sys- tem is fully formed, the systems of affect and behavior use the natural and vital energies for nutrition, growth, and development. They invest energy in objects that appear to fulfi l the needs of attracting pleasure and avoiding harm. However, because the systems of affect and behavior do not function cognitively, when their needs are not met, they automatically seek to displace their energies toward another object. Through observation and imitation, most often under the guidance of parents, the individual gradually develops cognition. Cognition allows the person to become selective and to choose what best satisfies the basic needs. The cognitive system is endowed by nature with the ability to identify and match the mental image arising out of a need with a real perception that will satisfy a natural disposition. Whereas the affec- tive and behavioral systems cannot differentiate between the impression of a desired object and the object itself, the cognitive system may come to know through learning that the impression and the real object are different and that the impression must conform to something real. The moral and religious training imparted by prophets, spiritual masters, and other teachers builds on this basic training or education (
tarbiyya
).