Voices of Islam (218 page)

The Functions

The primary functions or responses associated with the body and the human personality are attraction and repulsion. Both relate to the functions of the animal soul and its interaction with the humors and faculties. They are closely related to the behavioral and affective systems, especially with the desire to seek pleasure and the instinct to avoid harm.

The State of the Body

The human body may subsist in three possible states: health, disease, and a condition that is neither health nor disease, namely, convalescence or old age. The Prophet Muhammad said, ‘‘He who wakes up in the morning healthy in body and sound in soul and whose daily bread is assured, is as one that possesses the world.’’
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The Etiology of Disease

Islamic Medicine identifi six causes of disease: (1) air, (2) foods and drinks, (3) bodily movement, (4) emotional movement, (5) wakefulness and sleep, and (6) excretion and retention. Air is the essential element that keeps the body in equilibrium. Bad or polluted air disturbs the balance and equilibrium of the body. Hot food and drinks increase the heat of the bodily system; cold foods and drinks cool the bodily system. Movement increases

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the warmth or heat of the body. The ‘‘movement’’ of the emotions sets the soul in motion and may cause an internal disequilibrium that is visible symp- tomatically, such as with outward signs of disease. Strong emotional states such as anger, fear, grief, or extreme joy may be dangerous to the equilibrium of the body. Sleep was thought to cause the soul to ‘‘bubble’’ within the body, while cooling the body from the outside. Wakefulness heats the body. Finally, a balance between excretion and retention processes is thought to protect the body. Excessive excretions such as diarrhea dehydrate the body and upset natural balances, whereas infrequent excretions may keep damaging or poisonous substances within the body rather than expelling them to the outside.

Symptoms of Disease

The practitioners of Islamic Medicine saw the symptoms of disease as external signs (
‘alamat
) that provided evidence of internal states of imbal- ance or disequilibrium. Such signs could be ‘‘read’’ inductively, much as the world of signs (
ayat
) could be ‘‘read’’ to deduce the existence of God’s presence behind it. An example of how such signs of disease were understood can be found in the Egyptian scholar Suyuti’s book on the Medicine of the Prophet: ‘‘An excess of flesh is a sign of heat combined with moisture. Excess of fat is a sign of cold combined with moisture. In the same way, excessive desire for sleep is a sign of moisture, whereas a diminished desire for sleep is a sign of dryness. Similarly, the appearance of the organs [bulging through the skin] is a sign. Capacious organs are signs of heat, and the opposite is a sign of coldness. In the same way, dreams show temperaments. Seeing the colors yellow or red, or seeing flashes of light are all signs of heat. Their

opposites are signs of coldness. Again, an excess of body odor is a sign of heat; the lack of it is a sign of cold.’’
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ISLAMIC MEDICINE: PRACTICE

Diagnosis

The diagnostic process in Islamic Medicine is dependent on observation and physical examination. The most common sign of illness is fever. Accord- ing to the theory of Islamic Medicine, fever is a heat the body develops in order to compensate for a long-standing lack of heat within the body. A fever quickly hastens to refine the accumulated superfluous matters in the body by ‘‘ripening’’ them so that they can be eliminated. There are many types and kinds of fever, each requiring a different type of treatment.

To determine the relative harmony of the life force within the body, the

hakim
or physician evaluates the pulse. The pulse is a sign of the movement

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of the blood in the heart and the arteries, which expand and contract. Every beat of the pulse consists of two movements and two pauses: expansion- pause and contraction-pause. The quality of expansion and contraction is measured according to the length, width, and depth of the artery carrying the blood. The physician examines the quality of the pulse, the duration of its cycle, the duration of its pauses, and variations in the quality of the expan- sion of the arteries. The physician also checks the compressibility of the artery, the moisture and temperature of the body when he takes the pulse, and its regularity: in other words, whether its rhythm is normal or disordered. Pain is a sign of an imbalance in the body. Fifteen types of pain are identi- fied in Islamic Medicine, each calling for a different treatment. In
The Canon of Medicine
(
al-Qanun fi al-Tibb
), Ibn Sina described the effects of pain on the body from the perspective of Islamic Medicine. The effects of pain include (1) dissipation of the faculties, (2) interference with the functions of the organs, and (3) the alternation of heat and cold in the affected organ. The coldness of the organ that comes about with the persistence of pain is due to the dispersion of vital forces and the decrease of innate heat.
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Pain may be removed by a variety of substances: (1)
Resolvents
act in a way that is contrary to the cause of pain, thus removing the cause. Such resolvents may include anethum or linseed, which is made into a poultice and applied over the painful place. (2)
Narcotics
are agents that counteract the acrimony of the humors by soothing the body, inducing sleep, or dulling the sensitive faculties and lessening their activity. Narcotics used in Islamic Medicine include inebriants, milk, oil, and aqua dulcis. (3)
Analgesics
produce cold and thus increase the insensitivity of the affected organs. In addition, the body takes in nutrients, metabolizes them, and expels the wastes. Islamic Medicine stresses the importance of eliminants of the body and also uses

them as a key in determining a diagnosis.
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Treatment

Diet and herbal remedies are emphasized in the treatment of illness in Islamic Medicine. Through diet, incorrect foods causing imbalances in bodily systems are eliminated; herbal remedies help restore balance of the body. The first step in treatment is to detoxify the body of any superfluous matters that have gathered in the body, causing obstruction to the natural fl of the humors. The physician does this by cleansing the stomach and bowels in order to restore the digestive process. Elimination processes are important for the restoration of health. The body takes in nutrients and metabolizes them, and the by-products must be carried away. Often, the urine was exam- ined as a form of diagnosis. The quality of the urine was determined by color, transparency, and clearness, and also by the thickness, form, sediments, and residues that appear in the urine.

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Ibn Sina developed a Formulary that was one of the most important handbooks of medicinal treatments in the Middle Ages. It contained special prescriptions and antidotes. It also discussed the forms they should take, such as pills, powders, syrups, decoctions, confections, or elixirs, and their method of preparation. It also contained thorough discourses about laxatives, purgative and nonpurgative powders, medicinal powders, dosages, potions and thickened juices, jams and preserves, pills, herbs and cereals, lotions, ointments, and dressings and prescriptions for the treatment of different diseases.
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ISLAMIC MEDICINE: MORAL HEALING

In Islamic Medicine, issues of morality are treated much like physical illnesses. Classical Islam did not have a simplistic notion of sin. Islamic morality and ethics made a distinction between occasional lapses of judgment or morality, which are designated by the Arabic term
dhanb,
and the willful breaking of moral rules, which is termed
ithm.
The moral consequences of an
ithm
are much greater than those of a
dhanb.
Further- more, the Qur’an and Islamic traditions are quite clear that the person must take full responsibility for one’s failings. It was very diffi ult in Classical Islam to avoid personal responsibility by saying, ‘‘The Devil made me do it.’’ Chronic moral failings were treated as medical conditions, much like physical diseases. Just as physical diseases were caused by imbalances in the humors or in the working of the bodily systems, chronic moral problems were seen as psychic diseases that were caused by imbalances as well. According to the Shiite philosopher, scientist, and ethicist Nasir al-Din Tusi (d. 1274
CE
) the theory of the treatment of a moral malady is the same as the theory of the treatment of a physical malady: ‘‘It must be understood that the professional rule in treating imbalances is as follows: fi to know the classes of imbalances, then to recognize their causes and symptoms, and finally to proceed to restoration thereof. Moreover, imbalances are constitutional declinations from (a state of) equilibrium, while their treatment is the restoration of such constitutions to equilibrium by technical skill.’’
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Because moral diseases were seen as analogous to physical diseases, moral imbalances were treated by the same four categories of treatments as used in Islamic Medicine to heal physical ailments. One of Tusi’s most famous works was a handbook on the ethics and treatment of moral maladies known as
The Nasirian Ethics.
According to this work, ‘‘General remedies in medi- cine are effected by the use of four categories of treatment: diet, medication, antidote, and cauterization or surgery. In psychical [
sic
] disorders, too, one must make use of the same system.’’
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The first stage of treatment in Tusi’s approach to Islamic Moral Medicine begins with the awareness of a moral

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imbalance and the honest attempt by the afflicted person to own up to one’s negative traits and behaviors:

One should first clearly recognize the harm of the negative trait one seeks to change [i.e., gain cognitive consciousness of it]. There should be no doubt about it in order to have the necessary motivation to effect change. One should become aware though imagery of the harmful effects the negative trait has on the self, whether in one’s faith or in one’s worldly affairs. Then, at the next stage one should shun the learned negative trait by the use of will-power. If one’s purpose is attained, well and good. If not, one must constantly concern oneself with the application of the positive trait corresponding to that negative one, going to great lengths to repeat, in the most excellent way and the fairest manner, the acts pertaining to that function. Such remedies, generally speaking, correspond to treatment by diet as practiced by physicians.
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Once one has become conscious of a moral malady, it is necessary to seek its cause. According to the teachings of Islamic Medicine, moral imbalances may be caused by improper diet, just as the imbalances that cause physical diseases may be caused by diet. On the other hand, moral imbalances might also be caused by factors that we today would call ‘‘psychological.’’ In such cases, the ‘‘medication’’ for the disease consists of techniques that are analogous in many ways to modern psychotherapy. Key to this process is to use certain positive tendencies and motivations within the bodily system to overcome other more destructive tendencies. This acts as a sort of antidote to the cause of the moral malady. Tusi explains:

If, however, by this sort of imbalance [i.e., diet] the imbalance is not balanced, one must proceed to consciously chide and revile, to humiliate and reproach the self for the act in question, either in thought or by word or deed. If this does not produce the desired result and one’s purpose is to adjust one of either the two functions—behavioral or affective/emotive, then one must effect this change by the use of the other function, for whenever one is dominant, the other is dominated. Moreover, just as the natural, created purpose of the affective/ emotive function is to preserve alive the individual and the species, so the purpose of the behavioral function is to defeat the onslaught of ‘‘attraction to pleasure.’’ Thus, when they neutralize and compensate each other, the cognitive function has scope for distinction. This category of restoration to balance is analogous to the giving of medication by medical physicians.
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The use of an ‘‘antidote’’ in the treatment of a moral malady consists of restoring the balance of the moral system by applying remedies that act in opposition to the imbalance that created the moral malady in the first place. Thus, negative traits are countered by positive traits, hoping thereby that the interaction of these two traits will restore the psychological balance or mean. However, in moral treatment, as in all medical treatment, care must

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be taken so that the patient does not ‘‘overdose’’ on the remedy. An excessive zeal to apply virtue may be just as dangerous in its own way as an excessive weakness for vice:

If, again, the imbalance is not eliminated by [the previous] method, then, in order to eliminate it, one must seek help from the entrenched negative trait by consciously developing the opposite negative trait. However, one must always closely observe the condition of the self and notice any adjustment made in the condition. That is to say, when the [deeply entrenched] negative trait begins to decline [in terms of intensity] and approaches the mean, which is the place of the positive trait, the moral-seeker must abandon the course on which he has embarked in order not to incline from equilibrium to the other end of the continuum and thereby fall into another imbalance. This category of restoration to moral balance corresponds to the poisonous remedy to which the medical physician does not put his hand unless he is compelled to do so; and when he does, he recognizes the obligation to careful observation and monitoring the disorder so that there be no declination of the one disorder towards its opposite. ‘‘As for him who fears to stand in the presence of his Lord and keeps the self from passion, then surely paradise—that is his abode.’’ Prophetic traditions too command resisting the passions. The teaching of the Divine Law [does so] also. The Divine Law also enjoined the removal of negative traits from the self by good acts of the body. This constitutes the source of the specifi form of opposition found in the ethics of [the Sunni theologian Abu Hamid] Ghazali, etc., that is, the removal of a negative trait by removing its causes and the removal of causes by means of their opposites.
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