(Edited by Shahid Athar , M. D.)
Islamic Philosophy Of Medicine
Amanullah Khan, M.D., Ph.D.
"Nor walk on the earth with insolence; for thou canst nor rend the earth
asunder, nor reach the mountains in height." XVII:37
The belief is a very strong component of our religion. Islam itself means
submission to the will of Allah. the religion places tremendous responsibility
on the individual. It is the individual himself or herself that is answerable
for all his or her deed and no one else will help on the day of judgement.
"Namely, that no bearer of burdens can bear the burden of another;"
"That man can have nothing but what he strives for;"
"That (the fruit of) his striving will soon come in sight;"
"Then will he be rewarded with a reward complete"LIII:38-41
Thus, the principles laid down by Islam attempted to purge the society
of tribal traditions and ills and helped create a healthy society.
MUSLIM QUEST FOR KNOWLEDGE AND HARMONY AMONG
This is mostly a discussion of the philosophy of Islam as it affected
science in general and medicine in particular. As Islam spread rapidly
during the 7th and 8th centuries, Muslims came in contact with the older
civilizations. During this period of interaction, the Muslim philosophy
provided a perfect stage for the retrieval and preservation of olden literary
treasures. There was tremendous emphasis on acquiring knowledge. The
Arabic language served as flexible medium for translation of these works.
Great literary centers developed extending from India to Eastern Europe, as
the Byzantine and Persian Empires were annexed to the Muslim world and
the Greek medicine was way past its epoch. the school at jundeshapur, after
islam reached the Persian empire, was not only left untouched but the
learning at this institution was greatly encouraged. The learned were
patronized and given every facility for propagating knowledge. Most of
them were Christians or Jews at that time. The learning center and
Jundeshapur became fervent with activity during the period of Abbasids, It
served as a melting pot for Nestorian physician, Greek physicians who were
leaving Athens, and physicians arriving from India and Syria. It became a
large medical center. People were sent long distances in search of remedies
and medical knowledge. Many Greek works were translated into Arabic.
PERIOD OF TRANSLATION AND AMALGMATION:
Greek medical works, especially those of Galen were translated during
the early 9th century by a prolific translator Humayn ibn Ishaq and his
disciples in Bagdad, which became one of the great learning centers of that
period. He translated voluminous materials and many of these manuscripts
can still be found in the libraries of Constantinople. He also wrote manuals
and textbooks, for students, such as "Question on Medicine" (which was
in the question and answer form), "Ten treatises on the Eye" (the first text
book of ophthalmology ) and numerous other similar works. Humayan
demonstrated that he was an excellent editor because his writings were very
succinct, and translated from at least three different manuscripts of a book
so as to maintain and preserve the original thought. Compendiums of
medical knowledge were compiled discussing various diseases
systematically. This provides evidence of the understanding of medicine
even in those early days.
Hygiene was emphasized
Diseases of systems starting from the head,
ending at the feet
Each disease was discussed clearly giving the etiology, signs and
symptoms and the treatment.
THE ERA OF NEW KNOWLEDGE
Following this initial period of amalgamation and translation of Greek,
Persian, and Indian medicine, a great upsurge in new thought was seen
during the 9th and 10th centuries. I would like to quote the example of al
Razi - also known as Rhazes. He was a Persian Muslim who trained under
Hunayn ibn Ishaq. he must be regarded as one of the greatest physicians of
all times, who produced over 100 medical writings One of the most
comprehensive books on medicine was written by al Rize and entitled al-
Hawi. It consisted of 20 volumes. The diseases were described clearly
drawing on the experience of Greek, Arabic, Syrian, Persian, and Indian
physicians and he concluded by adding his won observations and experience.
his work on small pox and measles was translated for centuries to come in
other languages. The breadth of his wisdom and the scope of his understanding
of the humanistic and ethical problems faced by the physician can be seen
by merely looking at some of the titles of his works.
"Why People Prefer Quacks and Charlatans to skilled Physicians?"
"Why Ignorant Physicians, Layman, and Women have more Success
than learned Medical Men?"
"On the fact that even skilled physicians Cannot Heal All Diseases?"
These titles also suggest that in spite of vast understanding of medicine
as practiced at that time, he was well aware of the short-comings as a
This period saw numerous other physicians, both in the Eastern and
Western lslamic empire. One of the well known names of that period is Abu
Ali al-Husayn ibn Sina also know as Avicenna. One of his well known
books is the Canon of Medicine. This was an excellent encyclopedic work.
I could mention numerous works by Muslim physicians establishing the
influence of the Islamic period which molded the shape and future of
medicine. These works were read, translated, and repainted for many
centuries to come. Hospitals and medical academies were created throughout
the Islamic world. These also served as teaching canters for medical
students. where learned physicians taught medical science. Most of the
training was in the form of apprenticeship with experienced physicians.
There was also a system of granting diplomas and inspecting the skill of
physicians, pharmacists, barbers, and orthopedic surgeon. The annual
pilgrimage to Mecca also served as a factor in dissemination of medical
knowledge. Physicians would travel long distances, stopping to discuss
medical problems and their skills on the way to the pilgrimage, thus
disseminating their own knowledge and acquring new skills.
EMPHASIS ON PREVENTIVE MEDICIEN:
The philosophy of Islam in itself contributed to better hygiene and
principals of preventive medicine. for example, I would like to quote from
Hadith (the Actions and Sayings of Prophet Mohammad and his
"If you hear about plague in a land, don't go to it, but if you were in that
land, don't run away."
"No son of Adam would fill a container worse than his stomach."
"Tbe stomach is the home of illness and dieting the head of all
Cleanliness was also emphasized a great deal. Qur'an emphasized
"And thy garments keep free from stain." LXYIV:4
"O, ye who believe when ye prepare for prayer, wash your faces and
your hands to the elbows, rub your heads (with water) and wash your feet
to the ankles." V:7
Qur'an again emphasizes purity of food that you consume:
"This day or (on) things, good and pure make lawful unto you. The food
of the people of the Book is lawful unto you and yours is lawful unto them." V:6
Again from Qur'an
"Forbidden to you (for food) are: dead meat, blood, the flesh of swine,
and that on which hath been invoked the name of other than God; That
which hath ben killed by strangling, or by a violent blow, or by a headlong
fall, or by being gored to death; that which hath been (partly) eaten by a wild
animal; unless ye are able to slaughter it (in due form); That which is
sacrificed on stone (altars); (Forbidden) also is the division (of meat) by
raffling with arrows; that is impiety." V:4
The use of various intoxicant was prohibited. Qur'an refers to this as
"O, ye who believe intoxicants and gambling (dedication of) stones and
(divination by) arrows are an abomination of Satan's handiwork; Eschew
such (abomination), that ye may prosper." V:93
ISLAMIC PHILOSOPHY AND MEDICAL ETHICS
One of the hottest issues in medicine, these days, is the subject of
medical ethics, morality, and liability. If one looks back, it becomes
apparent that Hadith refers to these problems. It will also be of interest to
note that problems faced by the physicians and the patients today, are not
any different from the problems faced at that time. I would like to quote
hadith on the responsibility of the physicians.
"A person whoever practice treatment when he was not known to be
acquainted with medicine before, will be responsible".
Another Hadith delineates when a patient should seek treatment:
"You servants of Allah, seek treatment, for Allah didn't send down an
illness that Allah didn't send down treatment for it."
Hadith also make treatment mandatory or obligatory when a treatment
was definitely available and also if holding off this treatment would be
harmful. However, if one is not assured of benefits from a treatment and
harm could occur, then it is discouraged. These principals were designed to
discourage quackery and protect the patient.
One of the most extensive works dealing with ethics was written by
Ishaq ibn Ali al-Ruhawi. He as a Christian who embraced Islam and had
also written works on Galen. It wiU not be possible to cover all facets of his
writings. His book, Adab al-Tabib (Ethics of a Physician) is an extensive
work which cannot be discussed at length due to constraint of time. It
consisted of 112 folios with 17 lines per page. This was found in Suleymaniye
Kitabbane. English translation of which appears in the The Transactions of
the American Philosophical Society, Vol. 57, part 3, 1967, Philadelphia.
The Islamic philosophy served as a basis for defining and suggesting
solutions of the ethical and moral problems facing physician. the translator
of this work, Martin Levy, in his preface says, and I quote:
"In addition, the contents of this work are remarkable in their delineation
of the manner in which Muslim (and to lesser extent, Christians) religious
ideas were made to harmonize with the older science and ethics of the
Greeks in particular.
The Islamic philosophy and the Muslim code was so realistic and
practical, that al-Ruhawi was at ease in dealing with this difficult subject.
The society was changing from a tribal primitive society to a more orderly
society with emphasis on human value and strong religious feelings, These
were times of great changes. Therefore, the setting for this work was not any
different form the one prevailing at present. It may be worthwhile just to
glance at the titles of the 20 chapters of Adab at-Tabib,
1. Loyalty and Faith of the Physician, and Ethics he Must follow to
improve His soul and Morals.
2. Care of the Physician Body.
3. What the Physician Must Avoid and Beware of .
4. Directions of the Physician to the Patient and Servant.
5. manners of the Visitors .
6. Care of Remedies by the Physician.
7. What the Physician Asks the Patient and the Nurse.
8. What the Patient May Conceal from the Physician.
9. How the Healthy and ill Must Take Orders of the Physician.
10. Training of Servants by the Patient before illness.
11. Patient and Visitors.
12. Dignity of the Medical Profession.
13. Respect for the Physician.
14. Physicians and Peculiar Incidents to Aid Treatment.
15. Medical Art for Moral People.
16. Examination of Physicians.
17. Removal of Corruption of Physicians .
18. Warning against Quacks.
19. Harmful Habits
20. Care of the Physician Himself
Adab al-Tabib is a beautiful illustration of the fact that problems of
responsibility, ethical dilemmas, and needs of the society are nothing new
to medicine. A review of this work brings home the realization that the
present day physician may have been derelict in his responsibility towards
the current ethical needs. In the past, it was the physician who was the
advocate of morality, who defended ethics, and who was in the forefront in
delineating these areas. During the recent years, due to a verity of reasons,
such as busy life, narrow approach or lack of emphasis on ethics during his
medical training, he has failed to emerge as a stalwart among the defenders
of ethics and morality.
The definition of ethics and morality in medicine has lately become a
favorite topic for politicians and non-physician bureaucrats who lack the
insight into the whole gamet of patient-physician relationship. It is time that
the physician got back into the saddle and he is still in a great position to
do so. He is still regarded very highly and trusted by the people as shown
by the polls. Unless the physician takes proper steps, the public trust is likely
to wither away. Every teaching physician needs to realized his duty - to
train the budding physicians, not only in the art of medicine, but also in
handling the ethical dilemmas of medical practice.
In the present day controversies of medical ethics, certain other aspects
of the responsibilities of the other parties involved, which have been well
delineated by Ruhawi, have been completely ignored in the recent years.
For example, the responsibilities of the patient and the society towards a
physician. The patient has equal responsibility in the relationship between
the physician and the patient. Similarly, the society has to realize the nature
of demands placed on a physician and afford him the support that he may
need at times.