Application of Tibb-i-Nabi to Modern Medical Practice
Hakim Moinuddin Chishti (Robert Thomson, N.D.)
Medical practice in the United States is facing its most serious challenge in the past 100 years. While no medical system can be expected to have a monopoly on cures, to day allopathic medicine is facing an ever- growing number of unorthodox assaults, on top of the malpractice increase. And, these charges are being lodged despite the outstanding advances and cures which can be attributed to scientific medicine.
The chief complaints against the orthodox system are that it is often harmful, often ineffective, and often too expensive. Modern hospital medicine is vulnerable on all three counts. It uses techniques and drugs that are productive of many adverse reactions, cost too much and frequently do not cure. Indeed, Dr. Lewis Thomas, President of the Sloan-Kettering Memorial Cancer Center in New York, confessed in a recent interview, that all internists know that ninety percent of all illnesses get better by themselves.
In the late 1979's in modern and scientific America (and much of the rest of the developed world), there need be no concern for the plagues and diseases which leveled civilizations in the past: smallpox, poliomyelitis, cholera, measles, and especially systemic bacterial infection are simply not a threat to life. In one sense, then, men and women and children are much healthier than they have ever been in human life; yet, they are much more apprehensive and disappointed about their lives than ever before.
The reports of unnecessary surgeries, suicides, drug abuse, sexual perversion, alcoholism and a wide array of "nervous" disorders, affect the entire population. What is more the causes of death for most people cancer, heart disease contain a clue as to the true source and cause of the problem, the gradual withering away and withdrawal of the life Force itself. Still, women abort their children, everyone seems quite willing to ingest substances known to shorten their life span, and engage in life habits and patterns which demonstrably build disease.
Coincident with this growing lack of true health, there is an assault upon the very integrity of the physician, and the substantial proportion of malpractice suits are rooted in the common misunderstandings about medicine and responsibility for health. Patients feel that the doctor has all the answers and the patient is but a passive participant in the relationship. Such an expectation is beyond the ability of medical science to satisfy. Physicians themselves have difficulty overcoming the psychological and financial temptations involved in assuming such a role. Thus, they too fall into the traps inherent in relationships based upon unjustified dependency.
It is at this critical juncture, when Man seems to be losing the physical and psychological underpinnings necessary for rational life-that we must turn to our Gracious and Merciful Creator, Allah t'ala, for the infallible remedy and vital prescriptions for our time.
Insha allah, in this presentation, I would like to suggest some conceptual framework within which we can begin to utilize the most Complete and thorough Medical Tradition, that of the Holy Prophet Muhammad (AS), and arrive at a renewed view of man as healer and man as patient.
Allah t'ala tells us in Surah An'am, verse 17:
"If God touch thee with affliction, none can remoe it but He;" (VIII 7)
And, again, in Surah Yunus, verse 57, we learn:
"O mankind! there hath come to you a direction from your Lord and a healing for the (diseases) in your hearts, -and for those who believe, a Guidance And a Mercy". (XI57)
And, once again, in Surah Bani Isra'il, this idea is even made more clear:
"We send down (stage by stage) in the Qur'an that which is a healing and a mercy to those who believe... " (XVII / 82)
Similar revelations are contained in other verses in Qur'an, notably in Surah XXVI, verses 80 and 81; XLI, verse 44; Surah XVI, verses 53 and 69. These are the specific references to guide mankind to the revelation of the latest and complete code for the fit conduct of human life on earth, in order to maintain or regain health.
As Muslim physicians, there is a very special obligation upon us, to become models of human life lived in harmony with these commands of our Creator. To accomplish this, let us look for a moment at the very excellent and perfect example left to us by the Prophet Muhammad (AS), and conveyed to us in the Sahih Traditions of Muslim and Bokhaii. The first Appendix shows a preliminary listing of those topics having a direct bearing and relationship upon health, which is given with a specific instructions from our beloved Prophet (AS),
It is clear that far from being a general and vague guide to health, the Qur'an and Hadith of Islam, on the contrary, gives us most specific ordering of matters of healthy living, for all manner of public and private health, even to the contamination of food by pets!
As Muslims we are well aware of a fact kept hidden from the general public in the West, and this is that the most complete system of "natural medicine" ever devised has been extant for 1,400 years, presented in the fullest and miraculous order of Divine Commands from Allah, and lived out in example by the most profound human being in history. And it is by this example that the present health crisis may be met. For this is, above all, a crisis of faith, of faith in the physician, of faith in the human mechanism as healing process, of faith in the patient, but above all, a cynical loss of faith in God Himself. We have learned from the Hadith of the Prophet (AS), "We did not send down any disease, unless we have sent down the remedy with it." And so, as the disease is "loss of faith" in the ultimate sense, the cure is therefore "iman."
This does not allow for any incurable disease, including the so-called "terminal" cancers, for, by giving up hope and informing a patient of such "hopelessness" of their faith and hope. Maulana Jalaluddin Rumi has said in Fihi Ma Fihi, that "faith is superior to prayer", even, for faith is continuous, cannot be omitted for any excuse, and has its own benefit with or without prayer.
The main tenets of Tibb-i-Nabi, or "medicine of the Prophet," of course Proceed from this iman, and are contained first of all in the usual religious in-junctions known as the "Five Pillars of Islarn". We wish to review them briefly.
1. Shahadat. "Lailahailallah;Mohammadd-ur-rasoulallah." Imam Al-Ghazzali has Said, "Illness is one of the forms of experience by which man arrives at a knowledge of God; as He says, 'Sicknesses themselves are My servants, and are attached to My chosen. ' "If one is unable to have faith in the soul, in Allah, and in the seen and unseen worlds, then how could one expect to have any wellness in the fight with other "unseen" things, like microbes and viruses. It is in the first place precisely because people have turned away from the nurturing and feeding of the soul, that disease has taken hold and overpowered that pitiable and shruken soul.
2. Salat. The five daily obligatory prayers are the most magnificent form of food for our soul, as well as being a practical set of physical exercises which, if conducted regularly will banish so many of the common ailments such as lower back pain, arthritis, cervical misalignments, headache and other complaints-or at least greatly reduce their severity if they occur at all.
The recitation of prayers in Arabic language conveys an added benefit which can be described under the Science of Breath (nafas), which holds that the heart is the seat of manufacture of the breath, and the storehouse for the divine potentialities (sifat). These potentialities are conveyed about the body by various humours (akhlat), which must be kept in harmony.
The transmission of sound is important for maintaining or building health. After all, the Command for the Qur'an was, and is, "Recite!" For example, the long sound of aleph ('al' as in father) is known to vibrate i the heart plexus and stimulate the feelings of power, concentration, majesty and so forth.
The sound of "ya" or long 'c' in English (as in seen), travels up the nasal septum and stimulates the root of the pineal body, acknowledged by most Western biologists to be a vestigial remnant of a third eye, or light- sensitive organ. Even though its specific function is not known to science, a quick review of words and phrases in salat will show the place Allah t'ala has found for stimulation of this body throughout the day.
3. Ramadhan. "Fasting (sivawm) is the best medicine",is the claim of the latest natural food faddists, but this statement too comes from the comprehensive Tradition on Medicine of the Holy Prophet Muhammad (AS). The burden upon the digestive organs, stressed further by addition of so many chemical additives to food, stress toxins and consistient dietary indiscretion, places a very great labor upon the detoxifying systems for the body-primarily upon the liver-which may ultimately be seen to be the leading cause of degenerative disease.
4. Zakat. Every physician knows that if the subject of disease is looked into deeply enough, nearly all diseases can be said to originate in the mind. The psychological fears associated with not knowing if, or how, one is going to provide for one's dear ones, often leads to excessive drinking, depression, and suicide, among other things. The humane system of community preservation provided for by zakat, is a necessary component of any truly humane society, and therefore is incumbent upon all Muslims.
In addition, there is the added benefit of increasing one's humility and preventing one from becoming selfish and greedy, characteristics so prevalent in modern society, which harm others by withholding something from the less fortunate peoples' needs and affections.
5. Hajj. The pilgrimage for every physically and financially able Muslim usually is performed by adults who have met their responsibilities in life, and have in one sense "earned" this final religious journey, It gives the mature in life a hope for the future, a very great and exalted final Purpose and direction, a final re-ordering and re-affirmation of iman as one approaches the transition from human life on earth. While it is surely the best provision against senility, even the young who are fortunate to perform the Hajj, the benefits are perhaps still greater.
Any interested person can go much deeply into these topics, and they are repeated here only to suggest a mere glimpse of the superior benefits to be gained from following the injunctions of the way of life known as Islam. Advanced study of Islam yields rich source material in any field of human thought and behavior.
What needs to be stressed here, is that even if all of these acts were not called by the name "Islam", they would, if prescribed and enforced as a mode of treatment, produce profound effects entirely beneficial. In my own work, I often suggest to non-Muslims who come for health guidance, the movements of salat, cleanings of wazu, and certain elements of fasting, under the rubric of "health building". The results under such a regimen, which is nothing more than suggestion Islam, have been truly astonishing, with recovery of many serious chronic and degenerative diseases recorded.
The Appendix I gives the list from Hadith on health-related topics, but from a broader perspective we can gain even more, to include some of the giants of Islamic medicine as it has developed from the example of the Prophet Muhammad, when applied by the advanced Muslim minds to fields of scientific endeavor during various periods of human history.
While there are many physicians who command our utmost respect there is one man who stands out above all others, who is responsible for nearly all of today's pharmacology methodology, much of the nature therapeutics, and whose medical theories have maintained their authority through seven centuries of medical practice.
Abu Ali Al-Husayn ibn Sina-known in the West as Avicenna-was one of the illustrious physicians in recorded history. He was born in 980 A.D. near Bokbara in present-day Afghanistan. Though that was the center of learning of the time, he had exhausted all teachers of the day by the time he reached his teens, and in fact explained logic to his master. He received no formal education in the sciences or medicine, but had physicians working under his direction at the age of fourteen.
He is perhaps less known for his medical genius than for his philosophy. His book Kitab-ul Ansaaf (The Book of Impartial Judgement), in which, at the age of twenty-one, he answered 28,000 questions on theology and metaphysics, remains a significant and undisputed contribution to human thought.
Avicenna was extremely active in all realms of life, serving several times as a court minister and on more than one occasion was caught up in intrigues which led him to flight or to prison. He wrote whenever he could- in prison, on horseback, or in the wee hours of the night after working all day. He wrote in verse to instruct his pupils, and produced important works on Sufi doctrines and behavior.
He never had a library and wrote primarily from memory. He is (credited by scholars with an astounding outpouring of 276 works, touching on all aspects of human endeavor-medicine, natural history, physics, chemistry, astronomy, mathematics, music, economics and oral and religious questions. Among them is the greatest classic on medicine, the eighteen-volume Qanun-ul-Tebb (Canon ofMedicine), which covers and orders aU medical knowledge in the world up to his time. The Qanun has maintained its authority in medical practice and teaching for more than seven hundred years, and today remains the "bible" of medicine for practitioners in India (both Muslim and Hindu) and throughout the Near and Middle East. Large medical schools are devoted to teaching Avicenna's and huge warehouse complexes are strategically located to dispense remedies from the Qanun ...
The London Dispensary revealed considerable influence of Avicenna up until the end of the eighteenth century, and use of his remedies continued widespread into the nineteenth century, especially in rural parts of North America which rely upon "home remedies". It remains for Westem medicine to become familiar with and study this rich source of knowledge as one of the greatest sources of rational medicine ever devised.
Translations of Avicenna's Qanun remain incomplete. A British doctor translated and provided a commentary for the first volume, but the remaining volumes are locked in Arabic and Persian with some translations into the Romanic languages.
Western medicine, nor science, has not a figure to compare with Avicenna, and it seems unlikely that one would be produced from the present moulds, rather, a researcher becomes "known" for some so-called discovery, which passes out of fashion quickly, or the drug he devised becomes too dangerous for human use. How many chemical drugs are in use today, that were in use 25 years ago?
Can we now construct-with the foregoing as a foundations model for the Muslim spiritual physician, or simply, the hakim in the fullest and deepest sense of that work, as a new, or reborn figure who can function not only to meet the specific needs of the ever-growing numbers of Muslims in the West, but also as a model for the medical paraprofessional to work with modern doctors to the benefit of the patient? To what extent can modern allopathic medicine be allied with such a model? What are the educational and licensing criteria which can reasonably be established for the modern hakim in the West?
The first need is to establish a pilot training program for Muslim hakims. This would include the primary areas of Isclamic religious knowledge, of shariat, of the medical bases inherent in the application of what as usually taken as religious duties, and to present these subjects-these measures and rules for living-in a framework which satisfies the highest standards of academic criteria in the American model. This can be accomplished during a training period of two years of class work, with the basic curriculum to include anatomy and physiology, organic chemistry, botany and plant pharmacoloty (herbology), ligamentous tissue adjustment, dietetics and training in first aid and acute symptomology.
To answer such a need, primary textual materials must be developed from those already in use, but keyed to an selected for the Islamic basis of the instruction. Translation of more than one of the classic Islamic medicine tests is a sine qua non, which may be easiest from the Urdu materials which are widely available and already in use in hakimi curricula in Pakistan. Moreover, Works of such import as Qarabaadin-e Kabir, Qanun-ul- Tebb, the Formulary of Al-Samargandy and a few other works are an immediate need. Such texts could be available within twelve months if funding were made available, Insha allah.
In addition to the more or less bard science aspects of such a curriculum, the ideal of Muslim physicians-spiritual physicians-must be taught by example, by precept. For this purpose, practicing hakims from predominantly Muslim countries can be brought in as visiting professors on a one to four semester basis. Likewise, it would be a value to the students, to visit and observe traditional hakims at work in Islamic cultures.
The second Appendix provides an outline for just such a two year training program. It is suggested that following the two year program of education in the hard sciences and other course work, that at least three years be spent under direct supervision of a practicing hakim, to ensure that each student has gained a mastery of fundamentals before undertaking independent practice.
The application of this training to practice in and among, Muslim communities can best be effected in the context of the Masjid, in each city. It is well-known that the mullah or imam is the most frequently visited person in the pathway to health among traditional Muslim cultures. A recent study in Afghanistan showed that for each single visit to a modern pharmacy or medical doctor, the patient visited the mullah ten times.
There exists a very special role for those Muslim physicians who have been trained in Western medicine, and are licensed for its practice. For the ordinary American doctors reject out-of-hand any religious basis for treatment, and the use of herbs are considered in the realm of the "quack." But, there is overwhelming scientific support for using herbs and natural religious modalities for treating the sick.
The intention of establishing a specific Islamic modality in America, is not to compete with or disparage medical doctors. It is rather to provide the supportive counseling and day-to-day guidance as an integral part of one's deen, which cannot be practiced under existing models of medicine. The diseases of alcoholism and mental illness, for example, will respond well to natural herbs, detoxification and spiritual counseling, but the requirements in terms of time are severe
A hakim can fill this need better than any institutional form of therapy, or any known drug therapy. For the diseases of today are the diseases of the soul, and demand folly supportive environ ments and an Islamic way of life to effect a true cure. Drugs can never remove the causes of loneliness, estrangement of family members, lack of self-worth, pressures of environment-but Islamic medicine can. Medical doctors must be available for consultation by patient and hakim, whenever concern for pathology arises.
The question of licensing requirements for hakims trained under this program arises. The first amendment to the Constitution of the United States exempts the "practice of religion", from regulation, and the Supreme Court has consistently held that Congress shall make no laws regarding the practice of religion. Lesser judicial bodies, and statutory laws, have also exempted religious practice from medical practice acts. Since the hakims would be an integral part of the Islamic religious community, in fact at its very core, there would be no interference from regulatory agencies of the state. As the training of initial classes proceeded, there may be developed some form of recognition certificate from the IMA or similar bodies. In any event, criteria for practice would be well established.
A glance around the society we live in compels one to realize that there must be developed some alternative therapeutics to the allopathic model as it currently exists. There has been a proliferation of a truly amazing array of "natural" therapies, some of which are clearly based on wrong assumptions, and mislead people into further degeneration of the mental and physical health. As Muslims, we possess the latest and most complete Medical Tradition and are rapidly approaching the time when we may be in error to fail to actively promote this system and way of life.
We cannot assume that all of the edifice of research of Islamic Medicine is simply rank superstition, based as it is upon the Holy Qur'an? There will no doubt need to be some adjustments made in the time manner and places where we choose to present this system, but can any excuse be offered as valid to delay, when the cost is life itself, and the suffering- of so many people.
In Tucson, Arizona, in conjunction with the Chishti Mission and Masjld Tucson, we have successfully implemented a pro-ram according to the outline given here, and it is an active and thriving model in our community. This arose initially out of necessity, to serve those whom modem medicine failed, and from small success, Allah the Merciful has guided us along, Subhan allah.
We would therefore like to ask this 11 th Annual Convention of the Islamic Medical Association of the United States and Canada, to take an historic and forward-moving role, and formalize a program to implement the goals and ideals outlined heretofore in the field of lslamic Hakimi medicine.
Eventually, with a fully-functioning Islamic Medical Research Institute, along with the many dozens or hundreds of Muslim hakim practitioners, Muslims in America and the West can create the model of medical treatment for the future, secure in the knowledge and promise of Allah t'ala, that it is the only fit conduct for our lives on this earth, to follow His commands, and nature this tendency in our fellow men, in our children and in ourselves.
The utilitarian social,and medical systems pass out of vogue because they are based upon the ideas of man, and the ideas of man can never be eternal, cannot cover the whole ground of man's existence and nature. But ours is an Ideal, of true healing and remedy of the, soul and body, exemplified by the last and greatest of prophets, Muhammad (AS). Islamic medicine takes up the individual, but in his relation to the Infinite.
We therefore see that there is an indisputable necessity for a religious basis to work in healing and health, and this will continue to be so if mankind wishes to be successful and happy. All else is a mirage, misleading and absurd, empty rhetoric. in light of the matured experience of our ancestors in the faith of Islam.
What is needed today, more than all the advancements of science, is a return to the simple, eternal laws for living, as shown in the way of life of Islam. Resurrection of our health, of body, mind and soul, utilizing the medical traditions of Islam, as shown by the light of Islam the Prophet Muhammad (AS), is the true need for the salvation of the plagues which now disturb the souls of men.
In this uphill task, everyone will be required to make concessions and sacrifices, to earn the goodwill of mankind, and blessings of Allah.