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Paper Presented at the Annual Seminar of the Islamic Medical Association of Malaysia held on July 9, 1995 in Kuala Lumpur by Dr. Omar Hasan Kasule, Sr., MB ChB, MPH, Dr PH (Harvard) Consultant Epidemiologist PO Box 16032 Washington DC 20041 USA fax (703) 709 5305.
ABSTRACT
The following perspectives, definitions, or understandings of Islamic medicine or its practical manifestations are examined critically and it is concluded that none of them can, standing alone, be called ' Islamic Medicine': (a) Tibb Qur'an (b) Tibb Nabawi (c) Medicine in the early Muslim state (d) Traditional' Medicine of Modern Muslim societies (e) ijtihad on ethical, legal and moral issues in Medicine (f) Ethics of physicians (g) Scientific and medical miracles of the Holy Qur'an (h) Alternative medicine (i) Providing services for the needy (j) Advocating or lobbying for the less privileged (k) Elimination of social causes of ill-health (l) Basic and applied research. The semantic confusion between the adjectives 'Islamic' and 'Muslim' is explained. 'Islamic' refers to values, ideas, guiding principles, and application of the Qur'an and 'Muslim' refers to people who self-identify as Muslims as well as their activities and institutions. They may not follow all the teachings of Islam. Thus Islamic medicine, the ideal, is not the same as Medicine of Muslim societies, which is the actual historical or contemporary experience of Muslim societies. Islamic Medicine is defined as Medicine whose basic paradigms, concepts, values, and procedures conform to or to do not contradict the Qur'an and Sunnah. It is not specific medical procedures or therapeutic agents used at a particular place or a particular time. Islamic medicine is universal, all - embracing, flexible, and allows for growth and development of various methods of investigating and treating diseases within the frame-work described above. This definition calls for basic transformation of medical systems. Islamic medicine thus becomes the result of an Islamic critique and reformulation of the basic paradigms, research methodology, teaching, and practice of medicine. This process of conceptual transformation, also called Islamization of medicine, is described in detail in the paper. The end-results of the Islamization process will not be a medical system, therapies, or procedures for Muslims only but for the whole humanity because Islam is a set of universal and objective values. Islamization is not theologizing, localizing, or parochializing medicine but making it excellent for all humanity. The process of Islamization covers all systems of medicine. Priority is for western medicine because of its dominance. We have to start by critically examining and reforming the methodology of research. Knowledge is produced by research and we have to be on the producing and not the consuming end of the knowledge process. A new reformed methodology of research will be built using guidelines of the Qur'an on (a) objectivity (istiqamah) (b) unbiasedness (no hawa & dhann) (c) haqq (truth) (d) a holistic view of the universe, harmony and coordination (tauhid) (e) looking for causal relations (sunan Allah fi al kawn wa al insan ) (f) utility ('ilm nafi ), and (g) pursuit of excellence (ihsan). The next task will be reforming the values, ethics, and attitudes of medical training and practice.
KEY WORDS: ISLAMIC MEDICINE, ISLAMIZATION OF MEDICINE
1.0 OBJECTIVES OF THE PAPER
This paper critically examines different perspectives, concepts, definitions, or understandings of Islamic medicine and concludes with the general concept and operational definition that can guide the work of interested Muslim physicians.
2.0 BACKGROUND
The concept of Islamic medicine has been understood to mean different things by different people at different times. There has been a proliferation of writings on medicine from an Islamic perspective by both physicians and non-physicians (1-9) as well as a general interest in health-related issues such as diet, lifestyle, hygiene, and alcohol abuse (10-15). Scientific research on Islamic medicine has been undertaken by Dr. El Kadhi in Florida, USA as well as other Muslim physicians in other countries. Starting in the late seventies international conferences and conventions on Islam and medicine have been held in several countries (16-18).
The greatest confusion has been semantic. ' Islamic' and 'Muslim' Medicine have confused. The terms 'Islamic' and 'Muslim' are used interchangeably as if they mean the same (3). Najjar (19) made a praiseworthy attempt to deal with the problem of semantics by referring to medicine in the early Muslim history as "medicine in the Islamic State" instead of "Islamic medicine".
The semantic confusion between the adjectives 'Islam' and 'Muslim' need not to continue. 'Islam' refers to the values, ideals, guiding principles, and applications of the Qur'an and sunnah. "Muslim' refers to peoples who self- identify as Muslims as well as their activities, and institutions. They may not fully apply all the teachings of Islam. Thus Islamic medicine, the deal, is not the same as Muslim medicine, which is the actual historical. or contemporary reality of Muslim societies.(9). The continuing confusion in the minds of many Muslim physicians about what constitutes Islamic medicine calls for this fresh attempt at definition and conceptualization of Islamic medicine.
3.0 PREVIOUS ATTEMPTS AT DEFINITION OF ISLAMIC MEDICINE.
3.1 Definitions based on both performance criteria and values
Dr. Ahmed El Kadhi Presented a paper at the First International Conference on Islamic Medicine held in Kuwait in January 1980 (2) and proposed 6 distinguishing criteria of Islamic medicine. Using statistics and medical experience in the United States, he argued that modern western medicine did not fulfill the criteria of being (a) excellent and advanced (b) based on faith and divine ethics (c) guided and oriented, i.e. consistent and logical (d) comprehensive, in paying attention to the body and spirit, the individual and the society (e) universal in utilizing all useful resources and offers its services to all mankind (f) scientific.
Two of the six criteria require a re-examination. Criterion (a) should not be taken at face value . A medical system's excellence or advancement is a relative assessment based on the knowledge, resources, and needs at a particular place. Medical systems are continuously improving making it virtually impossible to classify them at a particular point in time as excellent. Criterion (e) about medicine being scientific could be better be defined as ‘based on objective research using all sources of knowledge available including revelation’. The term 'scientific' and 'scientific method' have been misused as representing objectivity when in practice we know that there are many in-built biases in today's medical research that reflect subjective opinions, philosophies, and world views as well as fraud and incompetence.
3.2 Definitions based on values only.
Use of values and ethics as defining characteristics was seen as an improvement on the definition of Islamic medicine using operational criteria because criteria are difficult to measure and compare across different systems of medicine. Dr.Kasule, in a paper presented to the First International Islamic Conference Kuwait(9) argued that Islamic medicine can be defined as value and ethics and not as any specific medical procedures or therapeutic agents. This definition allows Islamic medicine to be a universal all-embracing concept that has no specific or particular time-space characteristics. A definition based only on values is, however, too general to be useful operationally. Values can be very subjective and difficult to define exactly.
3.3 Conclusion
It is clear from the above that there is a need for a clear definition. In this paper 11 perspectives of what could be Islamic medicine or its practical manifestations are explored critically and a synthesis is made ending with proposal of a new definitions.
4.0 TIBB QUR'ANI
4.1 Medical reference in the Quran
The Qur'an and sunnah have many medical teachings that have been referred to by some authors as Islamic medicine. Tibb Qur'ani refers to verses of the Qur'an that relate to diseases of the body and the mind as well as their treatment. The Qur'an talks about physical ill health (20) and mental ill-health/diseases of the heart (21). Ultimate cure of diseases is from Allah (22). The Qur'an itself is a cure.(23). It contains supplications for good health as well as guidance on specific therapy such as honey (24), eating only good halal food and avoiding unhealthy haram food (25) and not eating in excess (26).
4.2 Scientific explanation of Quranic verses.
A lot has written about verses of the Qur’an and hadiths related to medicine (27,28,29). Attempts have been made to provide scientific explanations for Qur'anic verses related to medicine. For example: contagious disease, alcohol, human creation, and medical benefits of fasting. Attempts have been made to establish medicinal value of plants, mentioned in the Qur'an as food but not as cures. In general these writings have lacked scientific rigor or accuracy and have created more confusion than clarity. This approach can also mislead some people into thinking that they know the full reasons behind a certain Qur'anic injunction. Unless clearly stated in the Qur'an itself or by authentic sunnah, the reasons behind Qur'anic injunctions are unknowable to us with certainty. All we can do is research and make ijtihad, we could be right or wrong. We must have the humility to realize that we may not reach the whole truth and that the scientific explanation that we propose may be wrong or may be only part of the explanation.
4.3 Conclusion
The Qur'an is not a text book of medicine but a book of moral guidance. It contains basic information and guidance on medical matters leaving the room open for humans to under take research and fill in the details. Confining medicine to only the teachings in the Qur'an would make medical research teaching and practice very limited because the Qur'an is very selective in the coverage of details leaving the field open to humans to observe, search for and understand Allah's signs on earth.
5.0 TIBB AL NABAWI.
5.1 Definition of Tibb Nabawi
Tibb Nabawi refers to words and actions of the Prophet (PBUH) with a bearing on medicine. The Prophet (PBUH) received and gave medical treatment and encouraged others to do the same . We feel that those treatments in which the Prophet was the patient or those performed infront on him should be included in Tibb al Nabawi. Tibb al Nabawi is a complete independent system of medicine. It is valid and useful (30). It covers preventive & curative medicine, mind & body, spirit & matter, and medicinal & surgical treatments (27-32).
5.2 Source of Tibb Nabawi
Bukhari in his Sahih narrated 129 hadiths directly related to medicine (33). There are many others which are indirectly related to medicine.. In his book Al Tibb al Nabawi, Imam ibn al Qayyimal Jamziyyah mentions many medical conditions for which the prophet provided guidance (34, 35). Jalaluddin al Suyuti published a book on Tibb Nabawi and divided medicine into 3 types: traditional, spiritual and preventive (36). Al Habba al Saudaa was recommended by the Prophet (PBUH) as a general treatment and has been studied extensively (37). Dr. El Kadhi has conducted scientific studies on its immune effects that have been published in leading scientific journals in the United States (38). The Prophet (PBUH) enunciated a basic principle in medicine that for every disease there is a cure (39). This is an impetus for us to look for remedies; seeking treatment does not contradict Qadar (pre-destination)
5.3 Use of Tibb Nabawi today
Whatever the Prophet (PBUH) said or did was valid and must be followed because he never uttered any untruth even when joking. The attempt to distinguish between his medical teaching as a messenger and his teachings as a human living in Arabia at a particular historical epoch is not easy. The distinction exists but studying it will lead to no practical result. The question is whether all or some of the Tibb Nabawi should be used today. If the diagnosis and all the circumstances surrounding a certain illness episode today are exactly like those at the time of the Prophet, (PBUH) then we have no hesitation in saying that Tibb Nabawi should be used. In actual practice it is difficult to ascertain that the conditions are the same. Changes in disease pathology, the genetic pool of patients and medical plants, weather and climatic conditions are among many variables that may make a particular remedy recommended by the prophet not appropriate for a medical condition today of the same name. Using Tibb Nabawi that was appropriate in the past for a condition today that is different is like using the right drug for the wrong disease.
5.4 Tibb Nabawi: Prevention, health promotion and Spritual Aspects
A lot of Tibb Nabawi is preventive medicine and health promotion. al Suyuti (36) listed preventive medical measures such as food and exercise in his book on Tibb Nabawi. al Fanjari (40) listed verses of the Qur'an and sunnah showing relationship between Islam and the environment, epidemics, nutrition, mental health and sexual hygiene. Study of Tibb Nabawi reveals that there are spiritual aspects to healing and recovery. Prayer, dua, recitation of the Qur'an and remembrance of Allah play a central role. Psychosomatic diseases could respond to spiritual approaches such as salat and a prayer. Salat heals physical ailments (36)
5.5 Conlusion
Tibb Nabawi as reported to us did not cover every conceivable diseases at the time of Prophet (PBUH) neither can it cover all ailment today or in the future in the various parts of the world. This is easy to understand from the context that although the prophet (PBUH) practiced medicine, his main mission was not to teach medicine and he was not a full-time physician . The hadiths of the Prophet (PBUH) should not be looked at as a textbook of medicine. They should be used for the diseases that they dealt with. The proper way to get additional medical knowledge is through research and looking for signs of Allah in the universe (43). We can coclude that Tibb Nabawi contrubute to islamic medicine but can not be on its own be called Islamic medicine.
6.0 MEDICINE IN THE EARLY MUSLIM STATE.
6.1 Muslim contrubution to medicine
Much has been written about Muslim contribution to medicine (1, 3, 44- 52). Some is with justifiable pride. Some is exaggeration and manifests a certain amount of inferiority complex. We are trying to tell others that even though our situation today is bad we were great once upon a time and that we taught medicine to Europeans. Some claims about Muslim achievements in medicine are valid and provable where as others can not be sustained. Ibn Sina was undoubtedly a great physician whose influence spanned many countries but the claim that Al-Zahrawi was the first surgeon in the world (49) is an exaggeration..
6.2 Stages of Development of Muslim Medicine
Early Muslim medicine passed through 3 stages. The first stage, lasting from the 7th to the 9th century CE, was a period of translation of foreign sources such as Greek, Syria, Hindi and Persian into Arabic. Some of the then existing Arab folk medicine was also incorporated into the new system (54 ). The second stage, 9th-13th centuries AD, was a period of original research to add to and to enrich the translated materials. Hospitals and medical schools were established, medical procedures were refined, and physicians were licensed to make sure they had sufficient skills and knowledge. Dr. Jalal Musa (54) described the research methodology of what he called Arab medicine as empirical observation based on a detailed study of 2 representatives physicians: Ibn Sina and Al Razi. The third stage, after the 13th century, witnessed the decline of science and knowledge in general. The medical knowledge then known to Muslims was not lost; it was passed on to Europe to be the forerunner of modern western medicine.
Several factors contributed to the growth of Muslim medicine: (a) The impetus and momentum for inquiry and scientific exploration from the golden era of the Prophet (PBUH) and the Khulafa al Rashidina (b) Pax Islamica over a wide multinational empire with relative stability; allowing freedom of movement and exchange of ideas over a large area (c) rulers who patronized learning and research.
Early Muslim medicine had to decline eventually. The environment in which it developed was already in decline morally and politically. It was only a matter of time before the medicine itself declined the process being completed by about 1350 AD.
6.3 Nature of Early Muslim medicine
As early as the 3rd century AH. biographies of Muslim physicians were compiled and we know a lot about their activities and achievements (46-48). The early physicians were encyclopedic in knowledge being competent in many different disciplines. Some of them were not Muslim; others were recent converts to Islam. Many were influenced by Greek philosophy then very current. Ibn Sina was referred to as "al maullim al thalith" the third teacher philosopher after Aristotle and Al Farabi. Al Razi was called the physician-philosopher while Ibn Sina was called the philosopher -Physician (19). Some were very pious Muslims whereas others, being humans, had their personal weaknesses. Some of the physicians were close to and served the rulers of the time who led regimes that were not fully Islamic. It is therefore incorrect to generalize and treat every physicians and all medical knowledge at that time as a model for Islamic medicine.
Can the medicine practiced in the early Islamic state be called Islamic medicine? The Golden era of Medicine (Abassid era) came a long time after the golden era of Islam (Khilafat rashidah ). Medical knowledge was translated from other societies and Muslims added to it, made corrections and improvements. Islamic principles had an impact on the developing medical knowledge but could not have been the sole guiding spirit . It is noteworthy that the dean of early Muslim physicians, Ibn Sina, did not include an Islamic philosophical or ethical dimension when he defined medicine as " knowledge of the state of the human body in health and decline in disease. Its purpose is to preserve health and restore it whenever it is lost" (3).
6.4 Conlusion
We therefore conclude that this early Muslim medicine was ‘Muslim’ and not ‘Islamic’ The ancestors achieved a lot in their time. The challenge is for us to achieve even more in our times. They had their achievements and we must have our achievements. We can not copy what they did and use it in our times.
7.0 'TRADITIONAL' MEDICINE ýýýOF MODERN MUSLIM SOCIETIES
7.1 Revival of Traditional medicine
Today’s traditional Muslim medicine, remnants of medicine practiced in the early Muslim state (56), has been looked at as Islamic medicine. Traditional medicine is practiced as folk medicine or as recognized and officially sanctioned alternative medicine such as the Unani (Arab) medicine in the Indo- Pakistan Peninsula. The Indian government recognizes 4 traditional medical systems: Unani, ayurveda, siddha, and yoga.
The current effort to revive 'traditional ' Muslim medicine is part of a world wide movement that seeks to revive old remedies . There are several reasons for this: (a) Failure of modern western medicine to reach a big proportion of people especially in rural areas (b) The realization that there are good things in the traditional systems (c) Increasing assertiveness of third world countries vis a vis the west (Cultural nationalism) (d) Traditional medicine has the advantage of being more human, using no dehumanizing technology, and interest in the patient as an individual.
The World Health Organization passed a resolution in May 1977 that argued " interested governments to give adequate importance to the utilization of their traditional systems of medicine with appropriate regulations as suited to their national health systems"(57). The state of Kuwait is an example of the new interest in Unani medicine. It invited 2 Indian experts in Unani medicine to visit Kuwait and explore the possibility and potentiality of reviving Unani (Arab) medicine system in Kuwait. The 2 experts issued a 55-page report with 18 recommendations among which were : establishment of research institutes and libraries of Unani medicine, publication of journals, cultivation of medical plants in Kuwait or their importation from India, and building schools and medical colleges to teach this system of medicine(55).
6.2 Unani as an example of traditional medicine
We will confine our discussion here to the Unani (Arab) system of medicine in the Indo-Pakistan region as an example of modern Muslim 'Traditional' medicine. There are other similar systems in the rest of the Muslim World. Calling it Unani refers to its Greek origin. It was Greek in origin, written and developed by Arabic speaking Muslims. Many of the diseases names are Arabic
Unani medicine has its origin in ancient Greece. Hippocrates is claimed to be the father of both Unani and modern western medicine. Unani Medicine benefited from medical knowledge of ancient Egypt, Arabia, India, Iraq, Iran and China. It is reputed to have reached Baghdad, the capital of the Muslim empire, in the 8th century CE. Many major medical works were translated into Arabic in the period 750-850 CE. Muslim physicians added their own original discoveries to the body of knowledge. Unani medicine was introduced into India by Arab and Persian settlers. The Indian Ayurvedic medical system borrowed from the Unani system. Indians did not just copy the Unani system; they made additions. Therapeutic qualities of Indian plants were investigated and those found useful were incorporated into the system.
The Unani system is based on the humoral theory first popularized by Hippocrates. The theory, recognized as untrue today, holds that ill-health is due to changes or imbalances in the humors. Unani medicine relies a lot on the pulse in its diagnoses. It uses a variety of drugs of plant, animal or mineral origin. It is non-invasive in most of its treatment modalities. Diseases and disease conditions are classified according to the organ system concerned. In India the system has developed to a high degree of sophistication. Drugs are prescribed by dose and frequency. Practitioners of Unani medicine believe they can help western medicine solve some of its current problems(3)
Two practitioners of Unani Medicine, Razzack and Umm Fazal (53) argued that, "The Arab system of medicine is as much scientific as any other branch of modern knowledge,..... if by medical science we mean that branch of knowledge which treats diseases and provides their treatment in a systematic manner, following a definite method in its experimental research, employing observations in deducing principles, testing deductive and inductive conclusions by experiments, pressing into its service the accumulated experience of ages in the various branches of knowledge"
In the centuries of decline, The concept of Islamic medicine has sometimes, in ignorance, been reduced to ideas and practices that are either shirk or border on it: magical practices, fortune telling, amulets & talismans, claimed control and use of jinns. Magic or sorcery, sihr, have been mentioned in the Qur'an but the Qur'an is very clear about its nature ; it can not be beneficial medicine.
6.3 Conclusion
It is clear from the foregoing that there is nothing, Islamically speaking, to distinguish the Unani system from any other traditional system of medicine. The Unani system is local and not a universal ‘Islamic’ system because (a) it is not known to all Muslim societies (b) some of the beneficial medicinal plants employed will not grow in other parts of the Muslim World (c) It is confined to a particular time and particular place; Islam and Islamic medicine must be suitable for every place and every epoch.
8.0 IJTIHAD ON ETHICAL, LEGAL AND MORAL ISSUE IN MEDICINE
Biomedical technology has given rise to many issues that are of medico-legal or ethical importance(59). Muslim physicians and fuqaha have been meeting to discuss these issues . Seminars on Islamic views of some medical practices, held in Kuwait in April 1978 and Amman in 1992-1994 and were attended both fuqaha and physicians, discussed the sale of organs, cosmetic surgery, stored fertilized ova, the length of the menstrual period and the length of gestation (5, 58, 60 ). The Islamic fiqh Academy of the Organization of Islamic Conference (OIC) has in 6 sessions discussed transplantation, life support in terminal cases, milk banks, family planning and birth control, use of fetal tissue and organs in scientific experiments and organ transplantation (61). The problem encountered is that the physicians and fuqaha have different education backgrounds making it difficult for them to communicate effectively.
Resolution of medico-legal and ethical issues lies at the intersection or interface of medicine and Islamic sharia. It is a legitimate occupation of a Muslim physician but cannot itself be called Islamic medicine.
9.0 ETHICS OF A PHYSICIANS
9.1 Islamizing the physician
There is an argument that you can get to Islamic medicine by ' Islamizing ' the physician especially during training. Then you are sure that his research, work and practice will be in conformity with the teachings of Islam. Naqib (62) proposed a complete Islamically- based education system for an aspiring physician starting from elementary to post graduate levels.
Deep study of medicine with reflection shows the physician the majesty of the creator and this deepens and strengthens the iman (63, 9). A believing physician will be more ethical in his research and practice.
Medical practice can not succeed without ethics . Ethics ensures that the physician has the appropriate level of knowledge and skill, that he charges reasonable fees for services, practices correct etiquette with patients especially of the opposite gender and treats patients after their consent.
9.2 Definition of physics.
There have been several attempts to define medical ethics for Muslim physicians during the ancient and modern period. Al-Tabari described the Islamic code of medical ethics in 970 AD to cover: personal characteristics of a physician, obligation towards a patient, obligation towards the community, obligation towards the colleagues, and obligation to his assistants(64) The Islamic Medical Association of the United States and Canada adopted the oath of a Muslim physician in 1977 as an alternative to the Hippocratic oath. An Islamic code of medical ethics was also issued by the International Organization of Islamic Medicine in Kuwait to guide Muslim doctors in their daily work.
Amine and El-Kadhi (2) based medical ethics on the Qur'an "... physician must believe in God, and in Islamic teaching and practice in public and private life; be grateful to his parents, teachers, and elders; be humble, modest, kind, merciful, patient and tolerant; follow the path of the righteous; and always seek God's support. The Muslim physician must stay abreast of current medical knowledge , continuously improve his skills, seek help whenever needed and comply with legal requirements governing his profession; realize that God is the maker and owner of his patient's body and mind and treat him within the framework of God's teachings; realize that life was given to man by God, that human life starts at the time of conception, and that human life can not be taken away except by God or with his permission; realize that God is watching and monitoring every thought and deed, follow God's guideline as his only criteria, even if they differ from popular demand or the patient's wishes, not recommend or administer any harmful material; render needed help regardless of financial ability or ethnic origin of the patient; offer needed advice with the consideration for both the patient's body and mind; protect the patient's confidentiality; adopt an appropriate manner of communication; examine a patient of the opposite sex in the presence of a third person whenever feasible; not criticize another physician in the presence of patients or health personnel; refuse payment for treatment of another physician or his immediate family; and strive to use wisdom in all his decisions’.
9.3 Conclusion
Ethics alone cannot change a medical system. The saying of Othuman bin Affan is very relevant here "'Allah can remove things through the ruler what are not removed by the Qur'an. Ethics alone may not be enough to change the reality. The physician may be good and ethical but if the system is working in is unethical, he will be ineffective. We therefore can not define a medical system by its ethics alone.
10.0 SCIENTIFIC AND MEDICAL MIRACLES OF THE HOLLY QUR'AN
10.1 Study of the scientific miracles
Over the past 15 years efforts have been made to establish the 'scientific miracles' of the Qur'an .The World Muslim League set up an independent secretariat for this. Several international conferences, seminars have been held . Many books and video have been produced and have been used widely by dawa workers calling people to Islam. Maurice Bucaille was one of the authors who wrote about science and the Qur'an (64). The most investigated aspect as far as medical science is concerned is the field of embryology. This field intrigued ancient writers as well as modern. Al-Suyuti (36 ) wrote about embryology and referred to the Qur'anic teachings on the matter. Sheikh Abdul Majied al-Zindani ( 65) has been a leading scholar of embryology. He has collaborated with a leading embryologist and has several high quality publications. Whose main findings has been the correspondence of Qur'anic verses with scientific observations.
10.2 Purpose of the study
The concept of establishing scientific miracles of the Qur'an seems simple but has dangerous consequences and we have very strong reservations about its continuation. The stated reason for the effort of establishing the scientific miracles can be inferred from the Islamic epilogue to the book by Moore and Zandini (65) on embryology : “Allah gave signs to His Messengers to prove their truthfulness. These were in the form of miracles which man can not bring about...Allah has preserved the Qur'an from any alteration and made its letters and words part of the miracles of the Prophet's truthfulness . This miracle consist of the Lord's knowledge revealed literary in the Qur'an and by meaning in the hadith. As scientific knowledge advances we find that what has been discovered had already been mentioned in the Qur'an and hadith a long time ago. This reveals to us that knowledge which came upon Muhammad (peace be upon him ) must have come from Allah, as promised by Him.' Thus the miracle of the last of the Prophets is continuously renewed as time goes on ....The Qur'an has stated unequivocally, that the scholars (scientists included ) are the ones who will know that it is the truth (65)... The words of the maker are a great help to those who study the result of his work, the Qur'anic statements are therefore necessary to guide those who study Allah's creatures'.
10.3 Comparing Qur’an and Science
We feel that Qur'an is its own best defense or proof. Its miracle is within it and does not require any external scientific investigation to prove it. Any attempt to compare the Qur'an and science or put the Qur'an side by side with science is comparing unequals. Science is not stable . What are facts and proved theories today turn out tomorrow to have been wrong . Science is a product of human effort ; Qur’an is the word of Allah.. Besides deliberate fraud and falsification of research data , humans can make errors . The Qur'an on the other hand is revelation. No falsehood can approach it from any direction . Its facts are absolute, objective and do not change with time or circumstances . The very idea of trying to compare or relate 2 (two) such unequal things is in our opinion not appropriate. Another very dangerous consequences of this exercise is that science can establish a scientific fact in a verse of the Qur'an. This is a strong motivation for a non-Muslim to believe in the truth of the Qur'an, Suppose the science changes after some further research and the earlier theories are found no longer valid ? Will that disturb the belief of the individual concerned ? Will he lose confidence in science?
10.4 Conlusion
We therefore conclude that investigating scientific miracles of the Qur'an is at least a questionable enterprise. Before its long term results are understood, it will be advisable not to include it among the active perspectives of Islamic medicine.
11.0 ALTERNATIVE MEDICINE
Some authors have looked at "Islamic medicine " as a reaction to and a complete or partial rejection of modern western medicine. Other authors have looked at natural therapeutics (diet, folk medicine, Hakim's medicine, chiropractic, allopathy, naturopathy, naprapathy and hemeopathy ) from an Islamic perspective and have argued that they are encouraged by Islam and are alternatives to drug therapy that has several limitations (10)
We can not define Islamic medicine in a reactive rejectionist fashion. Islamic medicine is not just an alternative to western medicine. It is a conceptual umbrella that can include western and other types of medicine if they conform to its basic paradigms.
The so-called alternative medical systems do not all reflect the Islamic perspective. Many of them are actually western in origin and share many of the characteristics of the dominant western medicine system.
12.0 PROVIDING SERVICES FOR THE NEEDY
Kasule (18) in the paper titled "Islamic Medicine in Africa: new Perspectives and Challenges" proposed and made a case for "a new dimension of Islamic medicine in its relevance to solving the health problems of the poor and least privileged people in the developing world".
Medical care fulfills one of the maqasid al sharia: preservation of life. The Qur'an emphasizes the importance of life and caring others.
Providing services is just one function of Islamic medicine and would not be called Islamic medicine. Any system of medicine Islamic or non-Islamic, could provide service for the needy. Many medical problems of the poor can be solved by non-medical means such as better nutrition, sanitation, and housing that come under the Islamic mutual social support system, nidhaam al takaful al ijtimae.
We can therefore safely conclude that social service is not a unique distinguishing or defining characteristic of Islamic medicine.
13.0 ADVOCATING OR LOBBYING FOR THE LESS PRIVILEGED
Poor health on global or even local levels is not due to absolute lack of medical resources but their maldistribution. Some have too much whereas others have no access even to the most rudimentary of the services.
Kasule(18) argued that “... the health condition of the poor of the world are desperate ... participation in efforts to change these conditions for the better is a relevant, contemporary and future role for Islamic medicine. With the present corpus of medical and scientific knowledge, most of the health problems can be solved. What is lacking is the will and compassion on the part of the global community to enable benefits of that knowledge to reach the needy.”
Assuring access to care is one of the functions of an Islamized medical system but is not a unique defining characteristics.
14.0 ELIMINATION OF SOCIAL CAUSES OF ILL-HEALTH
Modification of behavior and lifestyle could eliminate a big proportion of disease. Malnutrition (excessive intake), alcohol and drug addiction, sexual promiscuity are underlying causes of much ill-health both mental and physical. Islam has adequate guidance on how to deal with these social problems. Solving social problems is not exclusively medical let alone Islamic medicine.
15.0 BASIC AND APPLIED RESEARCH
There are some medical problems affecting many people that are neglected in research because of political and economic forces. The victims of such disease s may not have the clout to lobby for research funding.
Islamic medicine would be very objective and decisions on research fundings would not be susceptible to non-scientific influences by powerful special interests.
Islamic medicine would look at such neglected research as a moral duty. Such research, however, could be a function of Islamic medicine but can not be a unique defining characteristic.
Application of Islamic principles of justice, equity, and fairness in medical research will not by itself define Islamic medicine but will contribute to it.
16.0 A NEW DEFINITION OF ISLAMIC MEDICINE
The following definition of Islamic medicine is proposed after consideration and rejection of the alternatives described above. Islamic medicine is defined as medicine whose basic paradigms, concepts, values, and procedures conform to or do not contradict the Qur'an and sunnah. It is not specific medical procedures or therapeutic agents used in a particular place or a particular time. Islamic medicine is universal, all-embracing, flexible, and allows for growth and development of various methods of investigating and treating diseases within the frame-work described above.
This definition calls for basic conceptual or philosophical transformation of the current medical systems. Islamic medicine thus becomes the result of an Islamic critique and reformulation of the basic paradigms, research methodology, teaching, and practice of medicine. This process of conceptual transformation, also called Islamization of medicine, is described below . The end -result of the Islamization process will not be a medical system for Muslims only but for the whole humanity because Islam is a set of universal and objective values. Islamization is not theologizing, localizing or parochializing medicine but making it excellent for all.
17.0 THE RATIONALE FOR ISLAMIZATION (ISLAMIC REFORMULATION OF BASIC PARADIGMS, ETHICS VALUES, AND RESEARCH METHODOLOGY)
17.1 Problems of western medicine
Western medicine has some paradigms that we do not accept as Muslims. Death is rejected as a natural phenomenon and resources are wasted in terminal illness. Aging is also not accepted as a normal process and research is now being undertaken to reverse its course. There is no balance and equilibrium in selecting treatment modalities. Treatments are selected for their effectiveness without regard to what other harm they may cause to persons and the eco-system . Some treatments of yesterday are the diseases of today. Too much narrow specialization leads to lack of a wholistic approach to the patient. The physician turns a blind eye to moral and social issue of the day that effect the health of his patients and claims that his responsibility is medical care only. Secularized medicine has no consistent set of ethics. Malpractice, fraud, physician misbehavior are common. Materialistic pursuits are predominant. The highly secular environment does not acknowledge a spiritual or religious dimensions in medicine. There are biases in selecting, funding and publication of research. Powerful political, economic forces that reflect the western world-view and philosophy of life are in control.
17.2 Limitation of the empirical scientific method as used in the west.
The scientific method and its empirical observation was bequeathed to Europe by Muslims. The Europeans took the letter but not the spirit of the method. They proceeded to misuse the method by making empirical observation and experimentation the only source of knowledge to the exclusion of revelation. The scientific method has the following characteristics: (a) open-ended and self correcting: theories are abandoned if not sustained by facts (b) repeatability (c) consistency (d) verifiability (e) Empirical knowledge is knowledge par excellence .
Western science's origins can be traced to Egypt, ancient Mesopotamia , and Greece. There was a decline of science in the Roman era and suppression of scientific inquiry in the dark ages by the Catholic Church. During the European dark ages. Muslims preserved and developed Greek science and systematized the empirical scientific methodology and passed their knowledge to Europe just before the renaissance. The renaissance was mainly this rediscovery of Greek knowledge . Renaissance was accompanied by the rise of rationalism, empiricism secularism and loss of trust in organized religion in the form of the Christian Church . This led Europeans to misusing the scientific method by claiming that it alone was the source of valid knowledge to the exclusion of revelation.
The present use of the scientific method has several limitation that many physicians are not aware of: limitation of human observation, limited sources of Knowledge, lack of a positive moral context , lack of complete understanding of the human being, absence of a wholistic system, and parochial or local Euro-centric context.
Human observations and senses have limitations in observing and interpreting phenomena. Some phenomena can not be observed/perceived correctly. The a priori assumptions, biases, and knowledge of the observer affect the observations and conclusions. It is therefore wrong to rely on empirical observation as the sole source of knowledge .
The two source of knowledge in Islam are wahy ( revelation) and kawn (empirical world ). Aql (intellect) is a tool given to humans to deal with wahy and kawn. Western epistemology denies wahy as a source of knowledge. European epistemology is basically materialistic. It denies religion or is sometimes actively anti-religion. It does not accept the unseen.(al ghaib) .
European science denies morality as a factor in its work. It operates in a presumed moral vacuum. There is no recognition of absolute morality. It attempts to solve social and medical problems of a moral or spiritual nature by use of technology.
The Empirical observation is itself not sufficient to fully describe and understand the human being and his society. Values, motivation, attitudes ,beliefs are difficult to measure let alone understand from empirical study. The observational tools available to the scientist, human senses and instruments (extensions of senses ), have an inherent inability to see the whole human picture . Additional guidance and information from the creator, the all-knowing, is needed. Only Allah knows and understands humans fully. Thus knowledge of humans that can come only from revelation, must be considered alongside the empirical observations for valid understanding. The scientific method has been directed to parochial and Euro-centric concerns and interests (political, military, economic). The priorities of research and application of knowledge are not based on objective and universal criteria. Western epistemology pretends to be universal. In practice it is parochial and reflects the cultural and religious heritage of Europe. Claim of objectivity by European epistemology is not true . Many of the so called objective empirical observations actually reflect biases and presumptions of the western World -view. Science is fragmented with no overall holistic picture. Narrow specialization has led to rapid advances in scientific research but in the process only the trees are seen but not the forest .
18.0 THE PROCESS OF ISLAMIZING MEDICAL SCIENCES:
Islamization of knowledge is the most urgent component of the contemporary Islamic Movement. Is a pro-active intellectual effort that is academically rigorous, objective and has practical consequences. The vision of Islamization is accelerated growth of objective, universal knowledge that is beneficial to all creations and allows a harmonious interaction of humans with their physical, social, and religious environment. The mission of Islamization is conceptual transformation of the paradigms, methodology, and use of disciplines of knowledge. The specific objectives of Islamization are : (a) De-westernization of the basic paradigms of existing discipline from being Euro-centre and parochial to being objective and universal (b) Reconstruction of paradigms of disciplines using objective guidelines (c) Re-classification of disciplines of knowledge (d) Reform of the methodology of research (e) Foster growth of knowledge through research (f) Assuring correct application of knowledge for human benefit and harmony of the eco-system.
Under the Islamization plan a new reformed methodology of research will be built using the guidelines of the Qur'an on (a) objectivity (b) unbiasedness (c) truth (d)Tauhid (e) looking for causal relationship (f) utility and (g) pursuit of excellence.
The scope of Islamization is : paradigms, methodology and uses of knowledge and not its contents. Contents is changing so rapidly that Islamizing it is futile. We must be at the producing and not at the consuming end of knowledge. Producing means research . When the research methodology is reformed, the contents will automatically be reformed.
The following are manifestation of misunderstandings of Islamization that must be cleared up.(a) "insertion' of Qur'anic verses and hadiths in scientific papers (b) searching for scientific facts in the Qur'an (c) searching for Qur'anic proof of scientific facts (d) searching for parallelism between Islamic and European concepts (e) using ‘Islamic’ in place of ‘European’ terminologies (f) adding supplementary ideas to the European corpus of knowledge (g) adding Islamic subjects to European school or University curricula. The process of Islamization has been wrongly defined as (i) Islamizing the scientist or researcher (ii) Advocating that Islamizing implies that all what was in the discipline was un-Islamic(iii) Islamization is theologizing knowledge. (iv)Islamization is producing knowledge for Muslims only (v) Islamization is limiting freedom of thought .
The main domain in which research and writing can be undertaken preliminary to Islamization of the sciences are : (a) clarification of basic relationships : wahy and aqal,ilm and iman, ilm and amal (action), and ghaib and shahadah (b) Classification of disciplines (c) Qur'an and philosophy of science (d) Qur'anic methodology of knowledge :. (e) Qur'anic world-view that encourages research, growth and use of knowledge (f) The traditional Usul methodology : strengths, limitations and needed further developments (g) The scientific method nature and limitations (h) Developing a new research methodology that is objective and uses all sources and tools of knowledge: revelation (wahy), logical deduction and induction (aql) and imperial observation (kawn) (i)revival of ijtihad and research (j) motivation to excel in knowledge (k) correct attitude to the use of science and technology.
Institutions committed to the Islamization process will have to formulate strategic plans that include the following functions (a) Mastering basics of Islamic science: The usul methodology, ulum al Qur'an and ulum al hadith, interpretation of the Qur'an and sunnah with the understanding of the changing time-space dimensions, knowing limitations of literal reading and interpretations (b) Islamic critique of basic paradigms of various disciplines of medical science (c) Islamic reviews of existing text-books and teaching materials (d) cumulation of published research relevant to Islamization (f) publication and testing of new text-books (g) establishment of specialized research programs.
An individual committed to Islamization will have to undertake the following tasks : (a) commitment to Islamization (b)mastering a specialty very well (c) getting minimum essential knowledge of usul methodology, Qur'an and sunnah (d) critiquing the discipline (e) orienting research to Islamization priorities (f) writing and publishing (g) net-working (h) teaching /inspiring others.
20.0 THE CHALLENGE TO EXCEL
Our situation today was described correctly by Imam al-Shafi more than a thousand years ago as quoted by Jalaluddin al Suyuti in his book al Tibb al Nabawi “After the science which distinguishes between what is halal and what is haram, I know of no science which is more noble than that of medicine..... Truly the people of the Book have overcome us and overtaken us in this supreme art" (36)
We feel that the process of Islamization will provide the intellectual stimulation and practical motivation for us to work hard in medical research so that we may become leaders of the field.
NOTES
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