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Background reading material for medicine and fiqh panel held on 15th April 2000 at the Kulliyah of Medicine, International Islamic University, Kuantan, MALAYSIA by Professor Omar Hasan Kasule Sr.
14.3.1 URO-GENITAL SYSTEM
A. Disorders Of The Urinary Tract
B. Disorders Of The Male Genital Tract
C. Disorders Of The Female Genital Tract
D. Infertility
E. Pregnancy, Delivery And Their Disorders
14.3.2 CARDIO-RESPIRATORY SYSTEM
A. Respiratory Disorders
B. Disease Of Blood Vessels
C. Diseases Of The Heart
D. Circulatory Failure (Shock)
14.3.3 CONNECTIVE TISSUE SYSTEM
A. Hematopoietic System (Dam)
B. Arteries, Veins, And Lymphatic Vessels
C. Locomotor System
D. Muscles
E. Other Connective Tissues
14.3.4 ALIMENTARY SYSTEM
A. GIT Diseases
B. Ibadat
C. Aadaat
D. Muamalaat
E. Others
14.3.5 THE SENSORY SYSTEM
A. The Visual System
B. The Auditory System
C. Chemical Sensation
D. Surface Sensory System
E. Others
14.3.1 URO-GENITAL SYSTEM
A. DISORDERS OF THE URINARY TRACT
HEMATURIA:
Wudhu with hematuria
Fasting in hematuria of sufficient amount to cause anemia
RENAL FAILURE:
Saum in renal failure
UROLITHIASIS
Pain triggered by physical movements in salat
Stress of hajj movements and triggering pain
Fasting and stone formation
NEOPLASMS
Types: renal carcinoma, transitional cell carcinoma of the bladder, cancer of the prostate
Hamaturia and wudhu
Leaking urine
URETER:
Disorders: stone, obstruction (spasm)
Salat
Saum
B. DISORDERS OF THE MALE GENITAL TRACT
SEXUAL DYSFUNCTION
Loss of libido: marriage with no sexual desire. Lack of libido as grounds for divorce of khulu’u
Impotence: nullification of marriage after a grace period of 1 year to try to recover function
Ejaculation: pre-mature, delayed, or no ejaculation as grounds for divorce
Priapism: physical harm to the spouse
Excessive sexual desire in one spouse and not the other
PROSTATE
BPH and incomplete urinary voiding, incompetence
Carcinoma of the prostate causing hematuria
PENIS
Genital hygiene and prevention of cancer
Circumcision and prevention of cancer
Proper cleaning under the prepuce for the uncircumcised
TESTIS and VAS
Testicular torsion is a urologic emergency. Its pain is so severe that it can lead to delay of salat.
Epidydimitis is an emergency that may delay salat
Testicular cancer: treatment may destroy reproductive function. Marriage and divorce
Cryptorchidism: Marriage and divorce
C. DISORDERS of THE FEMALE GENITAL TRACT
SEXUAL DYSFUNCTION
Loss of libido & enjoyment, dyspareunia, vaginismus: marriage and divorce
BLEEDING DISORDERS
Types: Menstrual, Pre-menopausal, Post-menopausal, and DUB (may be anovulatory due to hormonal causes or ovulatory due to organic causes)
Wudhu and salat: Menorrhaghia and passing through the masjid. Pre-menopausal and post-menopausal ‘spotting’.
Hajj: Pre-menopausal and post-menopausal ‘spotting’
Munakahaat: DUB and sexual relations. Iddat for the post menopausal woman.
CONGENITAL ANOMALIES
Vagina: septate or imperforate vagina preventing marriage consummation
Cervix: disorders cause infertility or frequent abortions
Uterus: disorders that prevent implantation lead to infertility
Fallopian tubes: Tubal infection is a common cause of infertility
Ovaries: infertility, hormonal disorders that affect behavior
INFECTIONS
Cervix: infertility
Uterus: infertility
Tubal obstruction: due to infection, inflammation and post surgical. Leads to ectopic pregnancy
Legal liability of husband for transmission of infection to wife
Can infertility be justification for taking a second wife?
NEOPLASMS:
Neoplasms of the ovary: treatment destroys reproductive function
Uterine fibroids lead to infertility, abortion, and bleeding. May have to be treated by hysterectomy
Adenomyositis:
Endometriosis leads to pain and infertility
ATROPHIC DISEASES:
BREAST:
Types of disorders: galactorrhoea, mastitis, carcinoma
Diseases and disorders of breast and effect on breast feeding. Mastitis, carcinoma.
Radical mastectomy has cosmetic effects that can affect marital relation
ANOVULATION
Has three causes: (a) CNS: hypothalamus: tumors, trauma, vascular (b) Pituitary: tumors (c) Stress, anorexia nervosa, pseudocyesis, bulimia (c) Thyroid: hypo and hyper (d) Ovarian disorders
HIRSUTISM due to androgen excess. Behavioral disorders.
DISORDERS OF GENDER DIFFERENTIATION and GENDER IDENTITY
Anatomical and physiological: hermaphroditism
Physiological: virilization due to hormonal disorders
Behavioral: takhannuth: effeminate men is a major sin, istirjaal (masculine female is one of the kabair)
Marriage and inheritance in indeterminate gender
D. INFERTILITY
DEFINITION
Failure to get pregnant after 1 year of regular intercourse. Involuntary infertility can be primary or secondary
CAUSES
Male factors: sperm anomalies, reduced sperm mobility, few sperms
Female factors: anovulatory dysfunction, tubo-peritoneal disease, and cervical disease
Others: advanced age, lower coital frequency, immune factors male or female
DIAGNOSIS
Documentation of ovulation
Evaluation of ovulation: basal body temperature, serum progesterone, endometrial biopsy
Semen analysis
Tubal-uterine evaluation: HSG (hysterosalpingo-oophorectomy); laparascopy
Post-coital tests
Sperm antibodies
TREATMENT OF MALE INFERTILITY
Repair varicocele
Vaso-epidydimostomy
Vasostomy
Repair ejaculatory duct obstruction
Treat ejaculatory disorders: eg retrograde ejaculation
Immune suppression for sperm antibody
Assisted reproductive techniques: intra-uterine insemination, gamete intra-fallopian tube transfer
TREATMENT OF FEMALE INFERTILITY
Ovulation induction may lead to multiple gestation
IVF and embryo transfer
Psychological management
LEGAL RULINGS
Infertility as basis for nullification of marriage
E. PREGNANCY, DELIVERY AND THEIR DISORDERS
COMPLICATIONS OF EARLY PREGNANCY
Maternal rubella infection leads to congenital anomalies in the fetus.
Recurrent pregnancy loss: primary and secondary. It may be spontaneous, incomplete, and missed (fetus retained after its death). Causes: (a) genetic, endocrinogenic, anatomic, immunologic, microbiological. Spontaneous abortion and post-abortion nifaas. Abortion may be complete, incomplete, and recurrent. Pregnancy loss may be a cause of stress in a family anxious about having a baby.
COMPLICATIONS OF LATE PREGNANCY
Diseases of hemostasis and pregnancy.
COMPLICATIONS OF LABOR
Pregnancy may be post-term necessitating induction of labor. Delivery complication may lead to difficult choices between saving one of the lives: mother or infant.
POST-PARTUM COMPLICATIONS
Infection and bleeding disorders
Post-partum depression
14.3.2 CARDIO-RESPIRATORY SYSTEM
A. RESPIRATORY DISORDERS
UPPER RESPIRATORY DISORDERS
Types of disorders: infections and allergies such as rhinitis, throat clearings, sinusitis
Salat: A person with URTI can be excused from leading salat because of difficulty in recitation of the Qur’an. Patients who are actively secreting virus or bacteria should preferably pray at home.
Hajj: Isolation and other forms of restriction may have to be applied for fear of spreading infection during hajj.
Social etiquette: patients with URTI should restrict their social interaction for example visiting others so that infection does not spread. Clearing of the throat and spitting is a bad unhygienic habit that should be discouraged.
LOWER RESPIRATORY DISORDERS
Types: bronchiectasis, lung abscess, TB, lung cancer
Dyspnoea: acute and chronic respiratory infections, pneumothorax: salat, hajj
Cough: repetitive cough may make recitation in salat difficult. ? Hemoptysis and repetition of wudhu.
Pain: Patients with pneumonia or pneumonitis will experience pain on recitation and prostration.
Respiratory support: patients on respiratory support can not recite Qur’an during salat.
Drowning, gharaq:
B. DISEASE of BLOOD VESSELS
HYPERTENSION
Orthostatic hypotension: Lowering of blood pressure on prolonged standing necessitates shortening the recitation to avoid standing for a long time. Prolonged sitting between prostrations may also be carried out. Rites of hajj like tawaaf will require frequent rest periods.
Cerebro-vascular disease: Syncope can occur as part of stroke and may necessitate delay of salat and hajj rites. Judicial proceedings have to be suspended until functional recovery.
CORONARY ARTERY DISEASE
Physical exertion in salat, hajj and coitus may trigger a coronary attack.
ANEURYSM
Physical exertion may lead to rupture of an aneurysm
OCCLUSIVE ARTERIAL DISEASE
Wudhu with cold water may trigger symptoms of Raynaud’s disease.
VENOUS DISEASE
Phlebitis: wudhu with water may exacerbate phlebitic symptoms. Tayammum is recommended in such cases.
Varicose veins: wudhu with water may be uncomfortable necessitating tayammum.
Emboli: Care has to be taken to make sure that physical movements in salat and hajj do not lead to dislodging an embolus
B. DISEASES OF THE HEART
CONGENITAL HEART DISEASE
Congenital heart disease may take 3 main forms: left to right shunts, right to left shunts, and congenital valve stenosis. The decision for surgical treatment must weigh the benefits against the risk in such young patients. Since these diseases have a large genetic component, decisions have to be made about having more children.
ACQUIRED VALVULAR DISEASE
The aortic valve may have stenosis or incompetence. The mitral valve may have stenosis or regurgitation. In either case care must be taken that physical exertion in salat and hajj does not lead to more severe decompensation.
PERICARDITIS
Restrictive pericarditis limits cardiac function. Care has to be taken in physical exertion in salat and hajj not to exacerbate the condition.
ISCHEMIC HEART DISEASE
The pain of ischemic heart disease is so severe that it may necessitate delaying salat. Anginal pain may be triggered by exertion especially in hajj. Those with a history of myocardial infarction should take care in physical exertion in salat and hajj. Sexual exertion may trigger an anginal attack.
CONGESTIVE CARDIAC FAILURE
Salat: Patients in CCF may be too weak to pray. Standing up for prolonged periods in salat may worsen the lower leg edema and compromise venous return even further. The muscle movements of salat may however have a beneficial effect in venous return. Hajj: Hajj is better postponed in CCF because the patient may not be able to withstand the extra physical exertion involved.
D. CIRCULATORY FAILURE (SHOCK)
PATHO-PHYSIOLOGY
There are 4 main types of shock: hypovolemic,cardiogenic, septic, and neurogenic. The causes of shock are: endocrine, metabolic respiratory, cardiac, vascular, GIT, gynecological, obstetric, and neurological disorders. Dehydration and hemorrhage can also cause shock. Resusciation in shock has 5 main elements: patwency of the airway, restoration of breathing and blood circulation, removing the disability, and exposure. The following are monitored during treatment: pulse rate, respiratory rate, blood pressure, pulse pressure, capillary refill time, temperature, urinary output, CVP, blood gases, and blood sugar. Specific treatment of shock is by blood transfusion and IV fluids.
IBADAT: In states of shock the physical movements of salat and hajj are not possible. Fasting is not allowed because of the need to replace body fluids.
AADAAT: A patient in shock may not be able to feed in the conventional way. IG feeding and IV fluids may be necessary
MUAMALAT:
QADHA:
14.3.3 CONNECTIVE TISSUE SYSTEM
HEMATOPOIETIC SYSTEM (DAM)
Anaemia is common in pregnancy. It is obligatory for the mother to take haematinics as directed in the interests of the fetus
It is obligatory on parents to provide sufficient nutrition to the infant to prevent anemia. Although breast-feeding is recommended for 2 years, it is not sufficient by itself after the 6th month.
ARTERIES, VEINS, and LYMPHATIC VESSELS
Peripheral vascular disease: patients with intermittent claudification may have to be careful in wudhu with very cold water. They also have to be careful in their movements during salat.
Elephantitis: Wudhu may be difficult especially if there are blisters and tayammum may have to be considered. It may not be possible to sit down in salat because of the size of the enlarged lower limb.
DVT and salat: Movements of the lower limb in salat may have to be limited when it is feared that an embolus may be released.
Varicose veins and wudu: tayammum may have to be considered in place of wudhu if water will cause pain or there are blisters and wounds or when the limb is bandaged.
Phlebitis, thrombophlebitis: tayammum may have to be considered instead of wudhu. Sitting down in tashahhud may be difficult.
C. LOCOMOTOR SYSTEM
BONY SKELETON
Disorders: The following are common congenital anomalies: dysplasia (achondroplasia & osteogenesis imperfecta); cerebral palsy due to neuronal injury; congenital club foot (talipes equinovarus); bow leg (genu varum; knock knee (genu valgum); developmental dysplasia of the hip joint; and scoliosis. They may limit the range of movements in salat. Fractures and various types of arthritis may also affect the bony skeleton.
Neck problems: The sideways movement of the neck in tasliim may be limited.
Upper limb: raising the hands in takbir may be restricted in cases of fractures and arthritis. Pointing with the index finger is required in tashahhud (KS 320). It is forbidden to point with more than one finger (KS 320) or to intertwine fingers (KS 320).
Lower limb: The prophet described the method of bowing, kaifa yakuun al ruku’u (KS 319). In lower limb pathology bowing can be restricted. Prostration is also difficult since it requires flexion at both the hip and the knee joints. Tawaaf in hajj may be difficult with lower limb pathology. It is allowed to be supported by a stick or a pillar in salat (KS 321).
Back problems: Pain and restricted movements of the vertebral column make bowing more difficult. Standing for prolonged periods may also be difficult. It is required that the back be straightened after bowing, istiwa al dhahar fi al rukuu’I (KS 320); this is not possible in cases of back pathology. Back pain may interfere with sexual function.
Knee problems: The prophet described the manner of sitting in salat, kaifa yakuun al juluus (KS 319). Sitting is required between every two prostrations, al juluus bayna kulli sajdatayn (KS 320) as well as in the last raka’a (KS 319). Restricted bending of the knees interferes with sitting properly. Knee problems may make tawaaf and sa’ay in hajj difficult.
Ankle problems: The prophet taught the proper way of placing the feet in sitting down, la yasaffu bayna qadamayhi (KS 320). These may not be possible with ankle problems.
Fractures & sprains: Wudhu may not be possible with open wounds and compound fractures and resort is made to tayammum. Pain due to sprains and fractures may limit movements in salat. Movements will not be possible at all when the limbs are immobilized. When a pilgrim has a fracture or becomes lame for any other reason, he is discharged from the rites of hajj and has to repeat the hajj later (KS 182).
Orthopedic fixation: Orthopedic fixation of some joints like the hip or knee joints may limit the range of movements possible in salat. In hajj tawaaf may have to be done in a wheel-chair.
Osteomyelitis: Pain may limit movements in salat. If there is a discharging wound, tayammum will be needed instead of wudhu.
Malignant neoplasm:
Osteoporosis: care has to be taken in movements in salat and hajj to avoid fractures
CARTILAGE
Oropharynx: Laryngeal, pharyngeal, or other oral disease may impair ability to recite the Qur’an and thus lead others in prayer. Public duties like leadership that require communication may be impaired. Pleas and evidence in court may also be affected.
JOINTS
Salaat al awaabiin wa al fisaal (KS 318).
Osteoarthritis and rheumatoid arthritis cause pain and limitation of movement. These limit the physical actions needed for salat and hajj
Degenerative disorders of the vertebral column: spondylosis (arthritis of the spine), intervertebral disc disease (herniation), spondylolisthesis (anterior displacement) impair ability to stand for long periods in salat as well as tawaaf and sa’ay.
D. MUSCLES
Injury to muscles will necessitate limitation of movements in salat while they heal.
E. OTHER CONNECTIVE TISSUES
Skin lesions: Skin lesions such as eczema, dermatitis, itch, discharges, rashes, and chronic ulcer are a reason for tayammum. If the skin is bandaged, the bandage is wiped with the wet hand
Hair: ihraam with insects in hair
INJURY TO LIGAMENTS
Injury to ligaments may limit movements in salat
14.3.4 ALIMENTARY SYSTEM
A. GIT DISEASES
ACUTE ABDOMEN:
The following are common causes of the clinical syndrome called acute abdomen: acute appendicitis, acute cholecystitis, perforated peptic ulcer, pancreatitis, diverticulitis, and PID. These are serious conditions that require emergency treatment.
PEPTIC ULCERS
Fasting may not be possible in advanced stages of peptic ulcers. Gastric ulcer and duodenal ulcer may be complicated by: perforation, hemorrhage, obstruction due to chronic fibrosis.
NEOPLASMS
The following are common gastro-intestinal malignancies: adenocarcinoma of the stomach, primary hepatocellular carcinoma, metastatic liver cancer, carcinoma of the pancreas,and adenocarcinoma of the colon. Carcinoma of the small intestine is rare.
ORO-PHARYNGEAL CAVITY:
Common conditions of the oropharyngeal cavity are: tonsilllits, sialedinitis, and neoplasms. The neoplasms are: Squamous cell carcinoma, carcinoma of the larynx, and salivary gland tumors.
DISEASE OF THE ESOPHAGUS
The common disorders of the esophagus are motility disorders (achalasia, spasm, reflux), strictures
Barret's esophagus, esophageal cancer, perforation of the esophagus. The esophagus is intimately involved in nutrition that any esophageal lesions interfere with proper nutrition. This may have implications for fasting patients.
DISEASES OF THE SMALL INTESTINE
The small intestine may be afflicted by the following conditions: obstruction, Chrohn's disease, and infections. Fasting by resting the intestine may be beneficial.
DISEASE OF THE LARGE INTESTINE
The common diseases of the large intestine are: diverticula, volvulus, ulcerative colitis, and chron's disease.
DISEASES OF THE ANUS
The common conditions of the anus are hemorrhoids and anal fissure. They may cause bleeding. Wudhu will have to be made immediately before the salat and for that salat only. It has to be repeated for every salat.
GENERAL CONDITIONS
Obesity: extreme obesity makes salat difficult because of the body weight. Saum is good for the obese.
Food poison:
B. IBADAT
NAUSEA & VOMITING:
Salat is delayed while anticipating vomiting because vomiting is najasat and will nullify the salat anyway. Vomiting nullifies fasting; it is recommended to continue fasting even after an episode of vomiting but make up the day after.
HICCUP
Hiccup in salat may make recitation of the Qur’an impossible.
PEPTIC ULCER, GASTRITIS:
In extreme cases of peptic ulcer disease the patient is exempted from fasting
FLATULENCE
Any incidence of audible smelt flatus nullifies wudhu. A general feeling of flatulence does not nullify wudhu
DIARRHOEA
A situation of continuous diarrhoea makes it difficult to maintain a state of wudhu
ANAL INCONTINENCE
In cases of anal incontinence, wudhu is made immediately before each prayer
UPPER GIT BLEEDING
Upper GIT bleeding that does not cause visible blood at the anal opening does not nullify wudhu
LOWER GIT BLEEDING (HEMORRHOIDS)
Bleeding from hemorrhoids and anal lesions and wudhu
ABDOMINAL DISCONFORT
Any cause of abdominal discomfort such as pain, cramps, spasms, and digestive disorders make it difficult to concentrate in salat.
CHOLELITHIASIS:
Pain of gall stones and salat
COLOSTOMY:
The colostomy is kept as clean as possible. Wudhu is made before each salat
ORAL CAVITY:
Halitosis: Bad oral smell due to caries, gingivitis, and oral ulcer is a reason for keeping away from public assemblies
AADAAT
MUAMALAAT
Disease transmission by feco-oral route and work in food service
E. OTHERS
14.3.5 THE SENSORY SYSTEM
A.THE VISUAL SYSTEM
IBADAT
The obligation of salat al jamaat and salat al jumaat is lessened for a blind person who has not guide to the mosque. A blind person can be muaddhin only if he has someone to tell him the correct time. He can also be imaam. The obligation to travel to Makka and perform hajj is considered id there are others to help him see the way.
B. HOLDING PUBLIC OFFICE
A blind person can be imaam/political leader if the visual impairment is not judged to impair performance of leadership functions. He can not be a judge because a judge in court must see the witnesses and must be able to assess their demeanor. He however can be a scholar or a mufti.
C. EVIDENCE IN COURT
Evidence requiring sight can not be accepted from a blind person. Other types of evidence are acceptable.
D. MARRIAGE
A blind person getting married without seeing and knowing the bride
Marriage to a woman with congenital blindness, man tazawaaja imra at wa biha baras (KS 550)
A blind person being waly
E. MUALAMALAT
Selling and buying by a blind person
Professional services by the blind
B. THE AUDITORY SYSTEM
CLINICAL CONDITIONS
Ear infections are otitis media and otitis externa interfere with hearing. Nose and para-nasal sinuses suffer from acute and chronic sinusitis. Assessment of hearing can be made using the Weber test and Rinne test
IBADAT
Hearing the adhan: Inability to hear adhan is not an excuse for not going to congregational prayers because one can rely on others.
Being muaddhin: A deaf person can be a muaddhin if there is a way for him to know the right time for salat
Being imaam: a deaf person can be imaam
Following the imaam: the deaf person can follow by imaam by watching what the imaam does even of he ca not hear
Teaching Qur'an: A deaf person can teach Qur’an but it is preferred he does not do so because he can not hear and correct mispronunciations.
Returning greetings: the deaf is not obliged to return greetings because he can not hear. He however is obliged to respond to sign language of greeting if he is sighted.
Sense of balance in salat and hajj (tawaaf): In vestibular disturbances standing up in salat or tawaaf may require support
HOLDING PUBLIC OFFICE
As imaam/political leader: deafness reduces competence as a leader but is not an absolute contra-indication
As judge: a deaf judge will not be able to discharge duties fully
As scholar/mufti: a deaf person can be a scholar and can give religious rulings because he can read the questions and can give either written answers or respond using sign language.
EVIDENCE IN COURT
Evidence requiring hearing: Evidence that assumes that the witness heard is not accepted from a deaf person unless the deafness occurred after the event. Such evidence could also be rejected if hearing is impaired and not completely lost.
Other types of evidence:
MARRIAGE
The marriage declaration: a deaf person can contract a marriage by use of reading or sign language
Declaration of divorce: A deaf person can declare divorce. The situation is complicated if the spouse being divorced in deaf because she can claim that she can not hear and understand the divorce pronouncement.
MUALAMALAT
Selling and buying: a deaf person can buy and sell as long as he understands the transaction and can communicate in writing or by sign language
Professional activities: It is forbidden for a deaf person to engage in any professional work such as driving a truck for which hearing is necessary.
C. CHEMICAL SENSATION
THE OLFACTORY SYSTEM (SHAMM):
Ibadat: In hyposmia the victim may not be able to smell flatus and thus may continue praying with an invalid wudhu. Hyperosmia and parosmia may results in unnecessary concern about presence of najasat where it is insignificant. The halitosis associated with fasting is due to reduced oral cleansing action of saliva. It can be reduced by increased oral hygiene.
Aadaat: Impairment of the taste sensation may reduce enjoyment of food. It may also impair ability to discriminate dangerous things and avoiding swallowing them. Halitosis due to disease or poor oral hygiene may make social intercourse difficult. It is especially offensive in the mosque.
Family: body or oral odor may cause so much distress in a marriage that it may lead to divorce.
Muamalat: Impaired smell may make transactions involving perfumes invalid because the buyer can not identify what is being bought. Similarly impaired smell may lead to buying of rotten products without knowing their true state
Court: Court evidence based on smell may not acceptable in situations of olfactory disorders.
Others: use of perfume to control body odor in public places like the mosque is mandatory to avoid annoying others.
THE TASTE SYSTEM (dhawq):
Ibadat: If taste is defective, it will not be possible to tell that water is polluted and is not suitable for wudhu
Aadaat: Enjoyment of food decreases when the sense of smell is defective. Dangerous food may also be consumed if it can not be tasted
Family:
Muamalat: in selling food and drinks, the buyer may use taste to make sure the product is wholesome. This is not possible when the sense of taste is defective.
Court: Evidence in court based on taste of products may not be accepted in cases of a defective taste sense
Others:
SURFACE SENSATION
Ibadat: loss of tactile sensation does not affect the processes of wudhu and salat in any major way however there is danger of being hurt without realizing
Aadaat: With loss of tactile sensation there is a danger of ingesting rough and dangerous materials
Family: Sexual sensation is a complex phenomenon that may be impaired when tactile sensation is lost and this may lead to stresses in marital life
Muamalat: Loss of tactile sensation may be a cause of accidents at work
Court: The integrity of the tactile sensation is considered when assessing certain types of court evidence
OTHER SENSATIONS
The Temperature Sensory System (Harara, Buruda): An impaired sensation of temperature may result in unnecessary exposure and heat stroke during hajj. Hot and therefore harmful food may be eaten when temperature sensation is impaired. Inability to adjust to extreme climatic conditions may be grounds for divorce. Workers must not be exposed to extremes of temperature.
The Sensation Of Pain (alam, wajau): extreme pain may prevent concentration in salat Pain may cause insomnia. Chronic pain due to PID and other causes of dyspareunia may create marital stress. Chronic pain may lead to psychological stress. Severe pain may lead to criminal behavior.
The Sensation Of Hunger (juu): Salat is delayed in cases of extreme hunger sensation, al ta’aam qabla al salay (KS 315). Loss of the hunger sensation is dangerous to life. Inability to extinguish the feeling of hunger with food intake may lead to loss of appetite control. Children may be severely undernourished when they do not feel hungry and refuse to eat food. Extremes of pain may lead to crime.
The Sensation Of Thirst (‘atash): concentration is salat is impaired in extreme thirst
DISCUSSION
UROGENITAL SYSTEM
Wudhu and salat with hematuria
Fasting in chronic hematuria complicated by anemia
Saum in cases of renal failure
Kidney stone pain and salat or hajj
Fasting in persons with predisposition to stone formation
Rulings on priapism
Excessive sexual desire
Benign prostatic disease and incomplete urinary voiding
Genital hygiene and prevention of male cancer of the penis and the female cancer of the cervix
Circumcision and prevention of cancer and genital infection
Cleaning under the prepuce for the uncircumcised
Ruling on treatment of testicular or ovarian cancer destroying reproductive ability and leading to marital stress
Rulings on dyspareunia
Wudhu and hajj in presence of pre-menopausal and post-menopausal spotting
Sexual relations in dysfunctional uterine bleeding
Congenital vaginal anomalies (septate, imperforate) preventing consummation of marriage
Cervical disorders leading to infertility or frequent abortions and marital stress
Tubal disorders leading to infertility and marital stress
Ovarian disorders leading to infertility and marital stress
Infertility as a reason for taking a second wife
Ruling on obligation of both spouses to undergo examination and testing for causes of infertility
Does radical mastectomy require husband's approval?
Rulings on anatomical and physiological disorders of gender differentiation
Rulings on psychological disorders of gender differentiation
Marriage and inheritance in cases of indeterminate gender
Rulings on therapeutic abortion in cases of maternal or fetal disorders
Rulings on choice of action to take in a complicated delivery in which only one life can be saved
Rulings on post-partum depression
CARDIO-RESPIRATORY SYSTEM
Obligation of congregational salat for person with upper respiratory infection
Rulings on isolation of persons with respiratory infections in hajj
Salat in states of dyspnea
Recitation in salat with a repetitive cough
Salat in status asthmaticus
Hemoptysis and repetition of wudhu
Salat of patients on respiratory support
Salat and hajj with orthostatic hypotension
Physical exertion in salat, hajj, or coitus triggering an anginal attack or rupture of aneurysm
Wudhu with cold water triggering Reynaud's sundrome
Wudhu in cases of varicose veins and phlebitis
Physical movements of salat and hajj dislodging an embolus in DVT
Decisions about future pregnancy after delivering a baby with congenital heart disease
Physical exertion in salat and vulvular heart disease
Salat and hajj for patients with congestive cardiac failure
Fasting in states of circulatory shock
CONNECTIVE TISSUES
Obligation on the pregnant woman to take hematinics to prevent anemia
Ruling on exclusive breast feeding beyond 6 months
Wudhu and salat for patients with elephantiasis
Tasliim with neck skeletal problems
Raising the hands in takbir with shoulder joint disease
Bowing and prostration in salat with lower limb pathology
Back problems and bowing or prostration
Sitting in salat and tawaaf with knee problems
Sitting in salat with ankle problems
Wudhu with a compound fracture
Orthopedic fixation and salat and tawaaf
Joint diseases (OA and RA) and salat & tawaaf
Wudhu with skin lesions, bandaged or not bandaged
GIT CONDITIONS
Fasting with peptic ulcer disease
Wudhu with bleeding hemorrhoids
Delaying salat when feeling nauseated
Wudhu and salat with continual diarrhoea
Wudhu and salat in anal incontinence
Wudhu and salat in upper GIT bleeding
Wudhu and salat with a colostomy
Halitosis and attending the mosque
SENSORY SYSTEMS
Obligation of salat and hajj on the blind
A blind person as a muaddhin or imaam
A blind person as a public leader or judge
Court testimony by a blind person
Blind person concluding a marriage contract
Blind person as waliy in a marriage
Transactions by a blind person
A deaf person as muaddhin or imaam
Obligation to return greetings for a deaf person
Deafness and public office
Deafness and teaching or issuing fatwa
Deafness and court testimony
Marriage and divorce by a deaf person
Transactions by a deaf person
Prevention halitosis in fasting
Bad smell in the mosque or other public places
Transactions with impaired sense of smell
Body odor as a cause of marital stress