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Presented at a training workshop on the Islamic Input in the Medical Curriculum held at the Faculty of Medicine UNISSULA on 21st December 2008 by Professor Dr Omar Hasan Kasule Sr. MB ChB (MUK), MPH (Harvard), DrPH (Harvard) WEB: http://omarkasule.tripod.com
1.0 PERFECTION, OPTIMALITY, INCOMPARABILITY
1.1 CONCEPTS
Allah’s creation is perfect. Allah is the best creator, ahsan al kahliqin (2:138 & 37:125). He perfected everything He made, kamal al khalq (27:88 & 95:4). He made humans in the best image, ahsan suurat (40:64 & 95:4). The process of perfection went through four stages: creation, khalq; making due proportions, taswiyat; balancing, ta ‘adil; and making the best image, taswiir. The biological perfection was created and not evolved. Every living and non-living things was created perfect de novo. All what Allah created has a purpose (23:115). This applies to the whole organism or its constituent tissues and cells. Order, nidhaam; harmony; and perfection, kamaal, are part of predestination, qadar, and are not accidental. Denying the existence of a creator is an intellectual and mental aberration that is incompatible with logic because perfection and harmony could not arise by chance. The constant physical laws, sunan al kawn, operate in both inanimate and biological systems. Every human is unique and is different from everybody else, a testimony to the power of the Creator. The human is created in the best and optimal fashion, ahsana taqwiim (95:4) and all biological systems are optimal. Change is governed by natural laws, sunan llah. There is a balance between constancy and change. The Qur’an challenged humans and other creations to create the like of Allah’s creation and proved them incapable of facing the challenge (7:191 & 25:35-36). Cloning, genetic engineering, and selective breeding are not de novo creations and can not be compared to Allah’s creations. No human or any other being can create new life, ‘ajz al shuraka ‘an al khalq (7:191 & 25:35-36). Human actions are imperfect.
1.2 MANIFESTATIONS: ANATOMY
Perfections of perfection and optimality are found in all medical disciplines. In anatomy, for example, parity in general (11:40 & 51:49), parity of gender (92:3 & 78:8), parity of organs (12:84 & 111:1), symmetry, both circular and lateral symmetry, laterality of left and right (7:17 & 84:7-8), adaptation of structure to function, consistency and predictability, and orderly change (staged, anticipated, and protective measures against mistakes).
1.3 MANIFESTATIONS: PHYSIOLOGY and BIOCHEMISTRY
Manifestations of perfection and optimality in physiology, biochemistry, & pharmacology are: the human organism functioning as a single entity (MB2018), correlation between anatomy and physiology, repeatability/replicability, specificity, specialization, complementality, co-operation, a hierarchy of importance, information processing/perception, reserve capacity in organs and compensation for overload. The complex human organism has few basic building blocks: amino acids, monosacharides, and fatty acids. The discovery of the periodic table of elements is one of the strong indicators that there is order in the universe. Metabolism of new synthetic molecules is a miracle of creation that needs appreciation. The finding that synthetic molecules can be metabolized by the biological systems indicates the existence of a unifying scheme of creation based on sunan al laahi fi al kawn.
1.4 MANIFESTATIONS: MICROBIOLOGY and PARASITOLOGY – not yet written
1.5 MANIFESTATIONS: BIOSTATISTICS AND EPIDEMIOLOGY
Manifestations of perfection and optimality in biostatistics and epidemiology are consistency & predictability, inference and causality, and probability.
2.0 CONTROL
2.1 CONTROL IN ANATOMY
There is centralized master control of physiological functions mediated by the pituitary gland, the hypothalamus, and the CNS. This control has a genetic basis in the form of DNA. DNA has 6x10e9 bits of information called codons. These represent 10E7 genes. Each gene codes for one protein molecule. Command and control in physiology relate very well to the concept of tauhid. For efficiency there must be a controlling center otherwise contradictions from many un-coordinated centers of control will lead to failure. An orderly and harmonious universe cannot have more than one master. Examples of control are the integrity of DNA despite continuous mitosis, normal cell growth, control of embryological development
2.2 CONTROL IN PHYSIOLOGY, BIOCHEMISTRY
Examples of control are control of balance (fluids, electrolytes, iron, acid-base, heat energy, and temperature). There is balance between entropy (disorder) and order, between coagulation and fibrinolysis, between sympathetic and parasympathetic systems, between left and right brain hemispheres, between anabolism and catabolism. Chemical reactions tend to an equilibrium as defined in the Hasselbach-Henderson law. Phenomena of control manifest as control of the heart beat, control of vomiting, control of swallowing, control of coughing, control of gagging, control of posture, control of micturition, control of defecation, control of lactation, control of parturition, control of cell membrane permeability, control of genetic expression, and control of hormonal receptors. Phenomena of periodicity manifest as cycling of matter between organic and inorganic and the circadian rhythm. Constancy and predictability are the basis for diagnostic tests and drug action.
3.0 HOMEOSTASIS, ‘i’itidal
3.1 THE QUR'ANIC CONCEPT OF THE GOLDEN MEAN
Four Qur’anic concepts relate to the golden mean: mizan, wasatiyah, tadhafu’u, and I’itidaal. Concept of mizan refers to balance. Concept of wasatiyyat refers to the center. Concept of tadafu’u refers to action and reaction. The concept of i’itidal refers to equilibrium. There is equilibrium between the internal and external environments. Homeostasis restores the normal state once it has been disturbed. Tauhid is related to homeostasis. Tauhid implies that the whole cosmos and what it contains have one deliberate creator. The contents must relate to one another in some harmonious way. It is unthinkable that the one creator could create systems that are contradictory to one another. The harmony must however be looked at in a dynamic way. Because there are constant changes, there must arise from time to time contradictions in the state of flux. There must therefore exist mechanisms for restoring the status quo after the changes have been accomplished. Thus tauhid and homeostasis are closely related. Feed-back may be positive or negative. Negative feed-back operates in homeostasis deviations from the norm are detected by specialized sensors and compensatory changes are triggered to restore the status quo. Positive feed-back is a very dangerous concept. If a change occurs, positive feed-back will reinforce it in a cyclic way that causes more of the same until all homeostasis is lost. The base-line is not constant. It changes with the environment and time. Variation can be within the range of normality or outside the range of normality. Change may be temporary or permanent. Sleep and fatigue are temporary. Lameness and blindness are permanent changes. The human body is in harmony with its internal and external milieu. The internal and milieu and the external milieu are themselves in harmony.
3.2 CARDIO-VASCULAR HOMEOSTATASIS:
The control centers are in the spine, medulla oblongata, the cortex, or the chemoreceptors. The input is from baro-receptors, chemo-receptors, cerebellum, and cerebrum. The output is through the autonomic nervous system to the heart and blood vessels. The hormonal factors involved are autocoids, adrenal medulla catecholamines, adrenal cortical hormones, and vasopressin. Oxygen and carbon dioxide have a direct effect on the smooth muscles of the pre-capillary sphincters of arterioles. Kidney auto-regulation also keeps blood flow at a constant rate. The integrated control of cardiac output depends: sympathetics, catecholamines, and increased venous return.
3.3 RENAL EXCRETORY HOMEOSTATASIS:
The kidney maintains plasma osmolality by ultra filtration followed by selective tubular reabsorption.
3.4 RESPIRATORY HOMEOSTASIS
Neural and chemical mediators are involved in respiratory control. The respiratory rate is controlled by the respiratory center, stretch receptors in the lungs, peripheral chemoreceptors, and central chemo-receptors. The diaphragm and the intercostals are responsible for respiratory movements.
3.5 GIT HOMEOSTASIS
There is balance of glucose, lipids, and nitrogen. Glucose is the final pathway of carbohydrate metabolism. The level of glucose in the blood is finely controlled. Glucose balance depends on dietary intake, rate of entry into cells, and the homeostatic activity of the liver. There is a balance among glycolysis, gluconeogenesis, and glycogenolysis. The level of free plasma fatty acids is finely controlled. It is increased by lipolysis. It is decreased by incorporation into lipoproteins, binding to albumin, and deposit as triglycerides. Plasma cholesterol is also kept in balance. It is increased by dietary intake, liver synthesis through a negative feed-back control, and breakdown of lipid stores. It is removed through feces and bile salts. Intake of nitrogen is dietary. The output is by excretion is in the form of excretion as urea and ammonia; about 80% of the ingested nitrogen is excreted as urea.
4.0 INTERACTION WITH THE ENVIRONMENT
4.1 CONCEPTS
The miracle of the human body is more startling when seen in its interaction with the environment. The interaction between the internal and external environments is purposive and is not a product of chance. The nervous and endocrine system ensure that the human body can adjust to rapidly changing circumstances of the external environment. This even includes changes on anticipation of external changes. The interaction between humans and their external and internal environments is part of Allah’s grand design and is not by mistake. This implies that this interaction has to be harmonious and follows the laws of Allah sunan llah fi al kawn. The human body is programmed to interact with the environment in the most efficient way. However humans because of their free will can behave in ways that produce unhealthy interactions. There are some phenomena like disease or drought that may bring adversity to humans. These are part of the grand design to ensure that there are checks and balances in the eco-system that ensure equilibrium. The adversities are therefore not created for punishment of humans. The universe was placed under the humans (taskhir). They control and change it as they want. However this control is sometimes not proper resulting into imbalances and problems. The crucial question is to determine what changes are bad because they derange the permanent fixed laws of nature, al sunan. A decision must also be made on what changes must be made for purposes of building a civilization.
4.2 THE PHYSICAL ENVIRONMENT
The human body is able to adapt to all types of physical environments. Human eucaryotic cells are less dependent on the external chemical environment that pro-karyotic cells. They have in a way created their own environment in their internal environment. Human can change environment. Some of the changes are for the good of the eco-system while some others are definitely harmful. Humans can sustain injury from the environment.
4.3 THE BIOLOGICAL ENVIRONMENT
The biological environment consists of parasites, animals, and plants. Humans and parasites have evolved a mutual adaptation. This takes several forms: symbiosis, commensalism, and parasitism. Parasites undergo antigenic change to avoid host immune defences. Plants are a source of food. They are involved in the oxygen, carbon dioxide, and nitrogen cycles that are necessary for human comfort. Human are able to eat some plants or parts of plants for which they have the appropriate digestive enzymes. Plants or parts of plants indigestable by humans still provide human food by being eaten by herbivorous. Under the concept of taskhiir, the earth and its contents were put at the disposal of humans. Taskhiir has its limitations based on the need to establish balance and equilibrium in the eco-system and protect humans from harm. Animals and plants are a source of food. Humans are at the top of the food chain and all food webs.
4.4 MICROBIOLOGICAL ENVIRONMENT
Micro organisms are viruses, prokaryotes, and eukaryotes. Viruses are the smallest infective agents and are obligate intracellular parasites that depend on the host for survival. In prokaryotes DNA is not bound in a membrane and there is no separation between the nucleus and the cytoplasm. Bacteria, spirochetes, mycoplasmas, and rickettsieaie are prokaryotes. Eukaryotes have their DNA separated from the cytoplasm. Protozoa, fungi, helminthes, arthropods are eukaryotes. There are 3 basic types of host-parasite relations: symbiosis, parasitism, and commensalism. Vectors transport parasites in disease causation. Parasites have to overcome overcome host resistance and barriers before disease causation. There is a balance sheet between the benefits and harm of microorganisms. There are many Islamic teachings about avoiding infections.
4.5 CHEMICAL ENVIRONMENT
Water is 45-75% of body weight. Tissues consist of inorganic substances, carbohydrates, lipids, and proteins. Elements higher concentration in humans than earth are H, C, and I. Elements the same concentration in humans and human body and the earth are P, S, Cl, K, and Ca. Humans take elements from the earth as food, drink and through respiration. C is the basis of organic compounds. Humans do not release dangerous chemicals into the environment eg ammonia is detoxified and turned into urea. Humans have complicated the simple chemical environment bequeathed to them by producing new chemicals.
5.0 ALIMENTARY SYSTEM, maidat
5.1 FOOD AS RIZQ
Food is needed for energy, growth, repair, and maintenance of the body. The Qur'anic term rizq means sustenance. It refers to to food useful to the body. Rizq is from Allah alone and He provides for all. The alimentary canal is a tube outside the body in direct contact with the external environment. Some food ingested at the mouth exits at the anus without entering the body. Digested food is absorbed by the intestines to enter the internal environment. The alimentary canal has a role in balancing the internal and external environments. It takes material from the environment, processes it, and returns it to the environment. Human appetite for food (a requirement for survival) is so strong that prayer is delayed when food is presented. Nutritional habits reflect underlying visions, beliefs, and cultural experiences. The alimentary system can be looked at as the final pathway for human corruption because food security is the underlying but often unstated purpose behind crime, corruption, treachery, amassing of wealth, aggression, and many other transgressions. Believer eat to get energy for ‘ibadat; non-believers may eat for enjoyment or to get energy for evil. A believer is satisfied with less food than a non-believer. The search for food and its ingestion is part of ‘ibadat. The human is rewarded for efforts to feed himself or herself. The ‘ibadat aspect is emphasized by the fact the feeding starts with the basmalah and end with the hamd. Fasting of Ramadhan is one the major acts of obligatory physical ibadat. It serves the functions of cleansing and protecting the body.
5.2 DIGESTION AND ABSORPTION:
Digestion takes place in the mouth, the stomach, and the intestines. The prophet taught measures to prevent oral infections: rinsing the mouth after a meal and use of the tooth-pick. He taught stopping to breathe during drinking because of deglutition apnea. The Qur'anic term batn refers to the whole gastro-intestinal tract or the whole internal cavity and not only the anatomical stomach. Humans have to eat at intervaks because of limited internal food storage. The limited storage enables them to engage in ibadat and other activities of human civilization without having to eat continuously. Besides its digestive function, the stomach acts to warn humans of impending starvation by its hunger pangs. The Qur'an mentioned the intestine as being destroyed by bad food.
5.3 ELIMINATION
The alimentary system separates the nutritious food to be absorbed from the non-nutritious one to be eliminated as waste. It protects the environment by detoxifyting ingested toxins or detoxifying metabolic products before elimination into the ecosystem. Feces are considered filth (najasat) largely because of their content of infective and toxic material. Proper disposal of excreta at both the individual and community levels is a mark of civilizational development. Islam started with a revolution in hygiene by teaching proper toilet etiquette and cleaning with water in both wudhu and ghusl. Hygiene is a pre-requisite for many humans to live together (civilized existence) because it prevents infectious and toxic disease.
5.4 MATABOLISM
The complex human food in all its varieties is in the final analysis reduced to a few chemical compounds after digestion (amino acids, glucose, and fatty acids). They are all finally reduced to Acetyl CoA that enters the Krebs cycle. The main purpose of the metabolic processes is to generate energy from food. The liver is the chemical intermediary between the alimentary system and the rest of the body. It is responsible for maintenance of the body's chemical and metabolic homeostasis. It is the great factory involved in both anabolism and catabolism. The liver is also the great protector of the body by detoxifying toxic substances from the alimentary tract.
5.5 GIT and NUTRITIONAL DISORDERS
The diseases of over-nutrition are obesity, diabetes mellitus, ischemic heart disease, and atherosclerosis. The prophet taught the rule of the thirds as a guide for food intake: one third for solid food, one third for water, and one third empty (Musnad Ahmad). He taught that Muslims do not eat until they are hungry and when they eat they do not fill their belly. Ibn al Qayim defined three levels of food: necessary, hajat, sufficient, kifayat, and excess, fadhlat. The necessary is for maintenance of life and health. The sufficient is for psychological satisfaction. The excess is harmful. Obesity is a result of excessive intake without matching physical exercise. In a hadith reported by Aisha, the prophet described obesity as one of the signs of social degradation.
6.0 URO-GENITAL & CARDIO-RESPIRATORY SYSTEMS
6.1 EXRETORY SYSTEM, jihaz bawli
The excretory system consists of the kidneys, ureters, bladder, and urethra. The system forms and voids urine and ensures fluid and electrolyte balance It ensures homeostatic control of the body by controlling and maintaining the volume, pH, and ionic composition of plasma. The kidney is the most important organ in homeostasis fulfilling the physical laws, sunan al kawn, relating to equilibrium and balance, tawazun & i’itidaal. Urine is filth, najasat. The Law teaches the importance of avoiding being soiled by urine and teaches measures to safeguard against urine. Washing of hands and the external excretory organs is required after urination. The use of the right hand is forbidden. Urine of breast-feeding infants is treated differently from that of adults in washing. The urine of female infants is also treated differently from that of males. Urination on the street or public places is forbidden.
6.2 GENITAL SYSTEM, jihaz tanasuli
The Qur’anic term farj is used to refer to the external genitalia of both males and females. External genitalia must be private and are considered part of ‘awrat. The uterus, rahim, had special mention in the Qur’an as the abode of the fetus. Fertilization and growth inside the uterus increase chances of survival of human fetii compared to frogs and fish whose ova are fertilized and grow outside and birds whose fetii grow partially inside. Female reproductive physiology manifests predictable cyclicity that is one of the signs of Allah, ayaat al llaah. The ovarian, menstrual, uterine, and vaginal cycles recur every month for 30-40 years of the woman’s life and are closely related to the human reproductive function. The menstrual flow lasts a few days and recurs in a cycle of 28 days on average. The menstrual cycle manifests one of the sunan of Allah because its duration of 28 days is the same as the duration of the lunar cycle. Menstruation is a normal process at the end of each ovarian cycle. Unlike Yahudiyyat, Islam does not make a menstruating woman a social outcast. Menstruation is a cause of physiological stress therefore fasting or prayers are excused. Copulation is a source of physical pleasure but has a deliberate reproductive function that is considered one of the Purposes of the Law, maqasid al shari’at. The Qur’anic term nutfat or mani refers to the male and female gametes that are the spermatozoa and ova respectively. Sex determination is not random but is determined by Allah. Sexual identity is a result of biology and socialization. Some deviant cultures encourage people of one gender to behave like those of another gender contrary to the teachings of Islam that emphasize very strong gender identity and a sharp demarcation between males and females. There are severe punishments for feminine men, al mukhanathin, and masculine females, mutarajilaat. Homosexuality is also severely punished.
6.3 THE HEART
The Qur’anic term qalb is not used in an anatomical sense. The heart is a pump that provides the energy to drive blood through the circulatory system. Parity of the heart is understandable from the embryological point of view. Separation of the left and right hearts ensures supply of well-oxygenated blood to the tissues. Control of the heart rate is by the electrical conduction system.
6.4 THE BLOOD CIRCULATORY SYSTEM
The prophet mentioned the flow of blood inside the body. Ibn Nafees was the first to describe circulation centuries before European writers. The circulatory system is an illustration of the sunan of equilibrium and control. Blood circulation follows biophysical principles and is another illustration of the unity of creation because physical and biological phenomena follow the same laws, sunan al kawn. The efficiency of the heart’s energy conversion is 20%, better than many machines. Blood flow to the skin increases in hot temperature to release heat. During digestion more blood flows into the GIT. During exercise cardiac output increases ten-fold and work done by the heart can increase 500-fold.
6.5. RESPIRATORY SYSTEM
The Qur’an mentioned the chest, sadr but not as an organ of respiration. The lungs are the main organs of respiration. The lungs provide a big opportunity for exchange between the internal and external environments. The term respiration can be used in 2 different ways to mean ventilation or tissue respiration. Coughing and sneezing expel irritants. In coughing the glottis is closed raising intra-ductal pressure to 100mm of mercury. When the glottis is opened suddenly, a jet of air under high pressure is released accompanied by the familiar sound of coughing. The glottis is not closed in sneezing but pressure still builds up. Sneeze is from Allah. Sneeze in salat is from shaitan. The prophet taught the etiquette of sneezing and yawning. The sneezer should praise Allah. It is obligatory for those present to respond to the sneezer. Respiratory movements have been used over the millennia as indicators of life. The Qur’an describes the last moments as sakrat al mawt as respiration begins to fail.
7.0 LOCOMOTOR and PROTECTIVE SYSTEMS
7.1 LOCOMOTOR / MUSCULO-SKELETAL SYSTEM, ‘idhaam & ‘adhalaat
The skeleton has three main functions of support, movement, and protection. It was mentioned in the Qur’an as bones, ‘adhm. Muscles are mentioned in the Qur'an as meat, lahm. Organs are used for worship, work, aggression, and sinning. Wudhu involves washing exposed organs of the body: the face, hands, forearm, leg, ear, mouth, nose, and hair. The upper limb is for manipulation and is specialized for manual dexterity. The lower limb is for posture and mobility and is specialized for weight bearing and walking. The sophisticated human hand is responsible for the advanced human civilization by making tools. The upper and forearms are levers to position the hand. The human upright posture allows use of upper limb free for manipulation. Control of posture and movement in humans is very advanced to enable upright walking. The musculo-skeletal system act as levers and pulleys with a mechanical efficiency higher than that of man-made machines. Continuous movement and exercise of the musculo-skeletal system is a physiological necessity for growth in infants and to prevent disuse atrophy. Salat is physical exercise repeated five times a day. The Prophet engaged in physical exercise and Omar Ibn al Khattab encouraged physical sports. Physical exercise is best undertaken while doing some work that is useful for the community. The human facial muscles are used in both verbal and non-verbal communication. Body language and body posture can convey very sophisticated messages and emotions. The vocal apparatus, the mouth, the tongue, pharynx, and the larynx, help in producing noises that may be happiness, anger, or fear. They also produce words that have enabled humans have the most sophisticated language and enable recitation of the Qur’an in a sweet voice.
7.2 SURFACES AND MEMBRANES
The Qur’an described skin as a site of punishment because of the sensory function. It also described psychological and physiological reaction of the skin to mention of the name of Allah. The skin will on the last day bear witness because it is used in sinful activities. The functions of the skin are: protection against mechanical injury, excretion through sweat, sensory input, temperature regulation, immune protection, protection against UV rays. Skin color is controlled by 4 pairs of genes. Chemically and optically, it is the melanin in the epidermis and the blood vessels in the dermis that define skin color. The density of melanocytes in the skin does not differ between darker and lighter races. Darker races have more active melanin production than lighter races. The primary purpose of melanin is to protect the skin against cosmic radiation especially ultra-violet radiation. Skin whorls and patterns are unique for each individual. The probability of two individuals having the same pattern is very low. Serous membranes allow smooth movement of organs and play a role in immune protection. Human nails unlike those of animals do not play a significant role in self-defense against attack. They are however used to scratch the skin and to improve grip for some small objects. Tears, sweat, and sebum play non roles in non specific immune protection. The number, size, and depth of melanin particles determine the color of hair from black to blonde. White hair has no melanin. Red hair has iron-rich pigment. Straightness and curliness of hair of hair depend on the shape of the pit of the follicle (straight sharply curved) or shape of hair shaft (round or oval). The pattern of baldness is under genetic control. Hair is part of female beauty.
7.3 THE ENDOCRINE SYSTEM
Functions of hormones are morphogenesis, hemostasis, metabolic regulation, and functional integration. The human hormonal system plays a major part in the flight/fight preparation. Modern sedentary humans have the same hormonal reactions as ancient hunters bit do not face the same physical stresses and risks. The hormonal cascade refers to the chain of command and control with ultimate central control in the hypothalamus. The flow of information is as follows: environmental signal, CNS, limbic system, hypothalamus, anterior pituitary, target organ, ultimate hormone, and systemic effects. The final hormone acts by negative feed-back on the hypothalamus, pituitary, and even the central nervous system.
7.4 THE IMMUNE DEFENCE SYSTEM
Immune defense is recognition and elimination on non-self (foreign) material. Immune defense may be cellular or humoral. Psycho-neuroimmunological research is uncovering what empirical observation has always shown that psychological factors such as stress affect susceptibility to disease.
7.5 HEMOSTASIS
The Qur’an mentioned blood as ddam. The chief function of blood is transport. It is also a buffer. The purpose of the hemostatic system is to maintain the integrity of the closed circulatory system in case of vessel rupture.
8.0 THE SENSORY SYSTEM
8.1 VISION
Vision is physical or moral. The eye is the organ of vision and emotional expression (sadness, pleasure, beauty, communication). Light is a condition for sight. The sources of light are the sun, the moon, the stars, and lamps. Darkness is either physical or moral. Human vision is limited, can be deceived by a mirage, and has poor speed and size discrimination. Blindness can be moral or physical.
8.2 HEARING
The ear is an organ of hearing. Biaural hearing is a bounty from Allah enabling humans to judge distance. Deafness can be physical or moral.
8.3 CHEMICAL SENSATION
Human smell and taste are weak. Odors may be pleasant or unpleasant. Smell and taste of food are appetizing, stimulates salivary and gastric secretions. Humans cannot smell out enemies but can smell or taste dangerous and discard harmful substances. The poor food discrimination of babies due to poor smell and taste enables them to like a wide range of food. Poor human smell is a bounty because they are spared many bad odors in the environment. Chemical sensations by chemoreceptors and osmoreceptors are useful in homeostasis.
8.4 SURFACE SENSATION
The Qur'an mentioned touch as lams or mass. The skin is a sensory organ. The hand is a sense organ that feels size, shape, and texture. The tactile ability of the hand is the basis of human civilization because it enables manufacture and use of tools. Touch can also be used to show love and intimacy. Earthly pain is less severe than pain in the hereafter. Somatic pain is a bounty for humans as an early warning of tissue injury. It is Allah’s bounty that most visceral pain is not felt. Heat is a punishment in the hereafter, and a discomfort on earth. It is Allah’s bounty to protect humans from heat by clouds and shades. Cold is the opposite of heat. Cooling rain water and cold drinking water are bounties of Allah. Hunger and thirst can be physiological, psychological, and moral. They are a warning to replenish food stocks before depletion and do not always indicate immediate danger or pathology. Diabetes mellitus is associated with hunger and diabetes insipidus is associated with thirst. Moral hunger manifests as loss of control of appetite and not getting satisfied. Hunger is a test and a punishment. There will be no hunger in jannat. The food of the dwellers of hell does not cure or satisfy hunger.
8.5 OTHER SENSORY MODALITIES
It is Allah’s bounty that humans are not consciously aware if visceral, kinesthetic or propioceptive sensation otherwise they would be overwhelmed by information. Allah wanted humans to concentrate on sensory input from the external and not the internal environment. The Qur’an and sunnat have described phenomena of extra-sensory perception (ESP) as inspiration, ilhaam; intuition, hadas; instincts, jibillat; and imagination, khiyaal; telepathy; dreams; and revelation. Scientific understanding of ESP is limited. Only dreams of prophets are true. The Qur’an and sunnat have condemned astrology, foretelling, divination, and sorcery.
9.0 THE NERVOUS SYSTEM
9.1 QUR'ANIC CONCEPTS RELATING TO THE NERVOUS SYSTEM
The Qur’an mentioned the functions of the nervous system (thought, memory, forgetting, and emotions) in association with 4 Qur’anic phenomena (naasiyat, lubb, qalb/nafs, fuaad, and dhihn. Humans have freedom of action on a limited scale.
9.2 STRUCTURE and FUNCTION OF THE NERVOUS SYSTEM
The nervous system consists of the central and peripheral nervous systems. Most physiological functions are autonomic not under conscious cortical control. Human behavior can be explained by the nafs, organic factors (chemical and anatomical), early learning, early conditioning, and socialization. Genetically-determined organic factors of behavior do not excuse humans from accountability because the nafs can override organic factors. Diet and environmental factors may also affect behavior. Humans can artificially change their behavior by using chemicals and intoxicants.
9.3 THE INTELLECTUAL FUNCTION, ‘aql
Intellect, ‘aql, includes conceptualisation and categorization, measuring and counting, concrete and abstract thought, causal reasoning, and problem solving. It cannot reason out all moral issues without guidance from revelation. It is very creative and imaginative. It is the basis of judgment (reconciling apparently contradictory information). It is is needed for sensory perception. It is needed for acquisition of knowledge. It is related to observation The 3 main intellectual processes are understanding, fahm; insight, idraak; and judgment, hukm. Consciousness, shu’ur, is both physical (awareness of the environment) and moral (sensitivity to immoralities in the community). Learning is related to memory and language. Humans think by manipulating verbal symbols. Communication is the basis for growth of civilization, family and social functioning, problem solving, and acquisition of new knowledge. The disorders of the intellect are kufr, shirk, junuun, jahal, and thought disorders (sterile argumentation, doubt, self-delusion, and conjecture).
9.4 MEMORY FUNCTIONS, dhhakirat, hifdh
Humans are capable of great memory but the capacity is not fully used. Short-term memory is recollection of recent events. Long-term is persistent recollection of distant events. Implicit memory is involved skills such as driving, eating, and drinking. There is a neurological basis for memory. Memory capacity can be enhanced by dua, strong motivation, and repetition. Memory can suffer from decay, distortion, confabulation, moral forgetting and physical forgetting. Shaitan is the cause of forgetting, moral and physical. Forgetting as a type of negligence cured by remembrance of Allah, dhikr Allah. Humans are not punished for forgetting. Reminding in a moral sense and the physical sense helps humans remember.
9.5 THE MOTIONAL FUNCTION
The qalb is the seat of emotions. Its emotional states can be expansion, inshiraah; stress, dhiiq; and calmness, tama'aninat. The basic animal drives are hunger, thirst, sex, self-protection & security, sociability, and inner promptings of the nafs. The food and sex drives are the strongest and both are necessary for survival of the human species. Humans have drives more and above the animal drives described above: honor, sharaf; altruism, iithhar, faith, iman, consciousness of Allah, taqwah, seeking the pleasure of Allah, ridhallah; seeking knowledge, talab al ‘ilm; appreciation of esthetic beauty, and self-actualization. Drives are inside and emotions are their external manifestations. Satisfaction of drives is associated with pleasant emotions. Dissatisfaction of drives is associated with unpleasant emotions. Drives cannot be denied or abolished but have to be controlled and channeled. Pleasant emotions are love, hope, elation, tranquility, mercifulness, and empathy. Unpleasant emotions are fear, rage, aggression, enmity, hate, hamm & ghamm, sadness, despair, laziness, and jealousy. Stress is tightness of the chest, dhiiq al sadr and stressful life, maishat dhankat. The opposite of stress is inshiraah al sadr. Stress involves psychological stress, dhiiq nafsi. Stressful events are traumatic, uncontrollable, and unpredictable. It is part of human nature to be inpatient and thus when confronted by a problem that cannot be resolved quickly they become stressed. Life is full of difficulties, ‘usr. Allah helps those in difficulty. He causes difficulty to be removed by ease. Each difficulty, ‘usr, is accompanied by what makes it easy, yusr. Patience is called for in moments of difficulty. Psychological reactions to stress are anxiety, anger, aggression, apathy and depression, cognitive impairment. The physiological reaction to stress manifests as the usual signs of adrenaline releases. Long-term stress affects good health. Emotional immaturity is basically refusal to accept and deal with emotions in a balanced way. Emotional disorders lead to behavioral dysfunction and social dysfunction.