Medical Treatment (al
by Prof.Dr.Omar Hassan
Basis for medical
treatment in the Qur'an and Sunnah
Every disease has a treatment
(KS p. 338). Humans are encouraged to seek treatment (MB#1962, KS
p. 338). The Qur’an described cure, shifa (p 637 3:49, 5:110, 9:14,
10:57, 10:69, 17:82, 26:80, 41:44). The Qur’an is a itself a cure
(17:82). Honey is described in the Qur’an as a cure (16:69). The
prophet Muhammad (PBUH) said in an authentic hadith that Allah did
not reveal any disease, bau, without also revealing its cure, dawau,
(MB #1962); some people may know the cure and others may ignore
it but it nevertheless exists. The Qur’an described disease in prophet
Ayyub (PBUH) and its eventual cure (21:83-84, 38:41-44). The Qur’an
described how Isa cured chronic diseases (3:49, 5:11).
Cure is from Allah
Humans try, but it is
Allah who cures, allah huwa al shafi (p 1105 21:83-84, 26:80, 38:41-42).
Humans should not be arrogant by attributing cure to themselves
and not Allah. In the same way humans can not refuse to take measures
to cure disease claiming that Allah will take care of it. It is
true that Allah cures but in some cases that cure operates through
the agency of humans. Sometimes the measures that humans take to
cure a disease may not be sufficient on their own to alleviate the
condition; it is Allah’s divine intervention and mercy that brings
about the complete cure.
and qadar (KS p. 338)
Seeking treatment does
not contradict qadar or tawakkul. Disease treatment is part of qadr.
The principle that applies here is reversal of qadar by another
qadar (rad al qadr bi al qadr).
Preventive medicine (tibb
This is a pro-active
measure. The Qur’an has used the concept of wiqaya in many situations
to refer to taking preventive action against entering hell-fire,
wiqaya min al nar), against punishment, wiqaya min al adhaab (p
1316 2:201, 3:16, 3:191, 3:34, 13:37, 40:7, 40:9, 40:21, 44:56,
52:18, 52:27, 70:11), against evil, wiqaya min al sharr (p 1316
86:11), against greed, wiqaya min al shuhhu (p 1316 59:9, 64:16),
against bad acts, wiqayat min al sayi’at (p 1316 40:9, 40:45), against
injury/harm, wiqayat min al adha, (p 1316 16:81), against jealousy,
wiqayat min al hasad), against oppressive rulers, wiqaya min al
taghoot (p 1316 3:28), against annoyance, wiqayat min al adha (p
1316 16:81), and against heat, wiqayat min al harr (p 1316 16:81).
Prevention is therefore one of the fixed laws of Allah in the universe,
sunan llah fi alkawn. Its application to medicine therefore becomes
most obvious. Disease could be prevented before occurrence or could
be treated after occurrence. The concept of prevention (wiqayat)
does not involve claiming to know the future or the unseen (ghaib)
or even trying ro reverse qadar. The human using limited human knowledge
attempts to extrapolate from the present situation and anticipates
certain disease conditions for which preventive measures can be
taken. Only Allah knows for sure whether the diseases will occur
or not. The human uses knowledge of risk factors for particular
diseases established empirically to predict disease risk. Preventive
action usually involves alleviation or reversal of those risk factors.
For example stopping cigarette smoking can prevent lung cancer and
ischemic heart disease. Obeying fire regulations can prevent fire
accidents. Careful driving prevents road traffic accidents and trauma.
Immunization prevents viral and bacterial infections. The concept
of prevention can be understood at three levels. Primary prevention
aims at making sure the disease does not occur at all. Secondary
prevention aims at limiting the impact of the disease once it has
occurred; this is usually by attempting to detect the disease early
and instituting necessary treatment. Tertiary prevention aims at
mitigating the long-term sequelae and complications of a disease.
Prevention also involves avoiding any act that can hurt good health
or destroy life, halaak (p 1261 4:176 … 67:28). There are activites
that promote good health and are part of preventive medicine because
they put the body in the best possible status to be able to fight
and overcome any disease that occurs. Examples of such activities
are: physical exercise, rest and recreation, diet, dhikr llah, happy
marriage and good family life.
Curative medicine (tibb
Every disease has a cure
that must be searched for and used (MB 1962). Curative medicine
may be invasive or non-invasive. Where possible non-invasive approaches
are preferred because invasive disease treatment whatever its nature
involves some element of risk to the patient. This risk is higher
the more invasive the treatment modalities are. A non-invasive approach
that aims at helping or assisting the body to fight the disease
is the best. Many physicians forget the tremendous potential that
the body has to take care of itself and cure disease with the help
of Allah. Medical treatment in most cases should be supportive to
the body’s natural healing processes. The body’s defenses against
foreign bodies are in the immune system which may be humoral or
cellular. Given the chance to fight back, the body is able to repair
damaged tissue with time.
Place of medical treatment
For millemia the home
has been the site of treatment. Increasing sophistication of medical
treatment eventually led to opening hospitals. The first hospital
in Europe was Hopital de Dieu opened in Paris in 600 AD. The first
Muslim hospitals, bamirstans, were opened before that. For a long
time hospitals were looked at as places where people went to die
and not places for recovery. The bad reputation arose from the fact
that most of those who went to hospitals did not return. The situation
has now improved. With available medical technology the hospital
makes a major difference.
MODALITIES OF TREATMENT
Among spiritual approaches
to disease management is use of dua from the Qur’an (17:82) and
hadith as ruqiy (KS p. 504). The Qur’an is the best medicine (KS
p. 338). Dua is medicine (KS p. 338). Asking for protection from
Allah, isti’adhat, is medicine (KS p. 338). A strong iman and trust
in Allah, tawakkul, play a role in the cure of diseases. Salat is
a cure (KS p. 338). The spiritual approach to cure is mediated through
the physical processes. Psychosomatic processes affect the immune
functions and other metabolic functions of the body. A believer
who is spiritually calm will have positive psychosomatic experiences
and not negative ones because he or she will be psychologically
healthy and at ease. Faith can change the very perception of disease
symptoms. Pain is for example subjective. A believing person who
trusts in Allah may feel less pain from an injury than a non-believer
with the same injury.
Among physical approaches
to disease management are: diet, natural agents (chemical, animal
and plant products), manufactured chemical agents, surgery (jiraha),
and physical treatment e.g. heat. Physical approaches can reverse
disease pathology, mitigate its effects or just stop farther progression.
of spiritual and physical
There should no dichotomy
between spiritual and physical. Both approaches should be used for
the same constitution. Each cures the disease each using a different
pathway. There is no contradiction but there is always synergy.
It is a mistake to use one and reject the other.
HALAL AND HARAM THERAPEUTICS
Some medicine is good
and others is bad. Bad medicine is forbidden (KS p. 341). Bad medicine
causes more harm than benefit. While seeking treatment, the moral
teachings of Islam must be respected. The end never justifies the
means. Haram material is not allowed as medicine except in special
circumstances where the legal principle of necessity (dharurat)
applies. Alcohol is for example not an accepted cure for any disease;
it is actually itself a disease.
SIDE-EFFECTS OF MEDICATION
The discovery of antibiotics
and other powerful agents and procedures effective against disease
has changed the face of medical care for the better in the past
50 years but has brought with it many iatrogenic problems. They
are always associated with side-effects or unwanted effects that
a good physician should be aware of and should look out for. These
problems are two-fold: (a) introduction of new molecules in drugs
into the body and the environment. The long-term effect of such
‘unnatural’ molecules is not known. (b) Invasive technology makes
drastic changes to human anatomy and physiology with its long-term
consequences still unknown.
The practitioners of
homeopathic medicine rightly criticize allopathic medicine for its
aggressive approach that is associated with many side-effects and
unwanted effects in the long and short terms. Homeopathic medicine,
practized in some societies and thought to have less side effects,
is clearly less effective for most conditions.
Harmful treatments are
not allowed in situations in which the cure is worse than the disease.
Choice of what treatment modality to use should involve a careful
weighing of benefits and possible harm or injury. It is a principal
of Islamic law (sharia) to give priority to preventing harm over
accruing a benefit.
The equilibrium between
benefit and harm of treatment modalities should be looked at using
three Islamic principles: tauhid, wasatiyyat, & shumuliyyat.
The concept of tauhid motivates looking at the patient, the disease,
and the environment as one system that is in equilibrium; thus all
factors that are involved with the three elements are considered
while making decisions. The concept of wastiyyat motivates the need
for moderation and not doing anything in excess. The concept of
shumiliyyat extends the tauhidi principle by requiring an overall
comprehensive bird’s view of the disease and treatment situation.
Many people with disease
conditions resort to superstition, magic, sorcery and divination.
These superstitions nullify ‘aqidat al tauhid. Superstition is distraction
from seeking true treatment. Patients delay coming to hospital and
by the time they come the disease is too advanced for easy cure.
Manifestations of shirk
practices in disease treatment include: amulets, ,tamaim,, divinations,
kahanah, and worshipping or asking cure from humans called saints,
awliyaa,, by visiting their graves. Other superstitious practices
usually associated with shirk are: claiming knowledge of the unseen
and claiming supernatural powers by any human. A fortune teller
(kahin) is a liar who pretends to know the future or the unseen
and provides information to the gullible clients.
ru’yat manamiyat (p 516 8:43, 12:4-6, 12:36, 12:43-44, 12:100, 21:5,
37:102, 37:105, 48:27, 52:32) Superstition could also be in the
form of dreams and their interpretation (tafsir al ahlam). It is
true that humans dream. Most dreams are related to the daily human
experiences. Sometimes because of the state of sleep the facts become
distorted such that a person can not relate the dream or understand
it. In such cases the Qur’an tells us that only Allah knows for
sure the correct interpretation of dreams. Limited ability to interpret
dreams was given to some prophets (p 221 12:6, 12:21, 12:36-37,
12:44-49, 12:100-101). Other humans do not this ability.
Some people practice
witchcraft or sorcery, sihr. The Qur'an condemns and forbids sorcery
in all its forms and manifestations (p 1248 113:4, p 566 2:102,
2:102, 5;110, 6:7, 7:109, 7:112-113, 7:116, 7:120, 7:132, 10:2,
10:76-77, 10:79-81, 11:7, 15:15, 17:47, 17:101, 20:57-58, 2:63,
20:66, 20:69-73, 21:3, 23:89, 25:8, 26:34-38, 26: 40-41, 26:46,
26:49, 26:153, 26:185, 27:13, 28:36, 28:48, 34:43, 37:15, 38:4,
40:24, 43:20, 43:49, 46:7, 51:31, 51:52, 52:15, 54:2, 61:6, 74:24).
Sorcery and its practice are superstitions that believers should
There are people who
hang objects on their body (azlaam) for protection instead of relying
on Allah (p 97 5:3, 5:90). Such actions are very demeaning to humans.
How can a human who possesses an intellect rely for protection on
a small object that he manufactures himself and hangs around his
Involvement of jinn
Jinn possess power that
is used to misguide and give credibility to shirk and superstition.
The jinn do not know the unseen ( p 289-9 15:17-18, 34:14, 37:6-10,
67:5, 72:8). A good Muslim should not be involved with jinn's and
should ask Allah for protection against them (p 288 3:36, 7:200,
Astrology is the belief
that movement of planets, stars, the sun, the moon can affect peoples’
lives. The astrologer uses these phenomena to make predictions about
disease or its cure. The astrologer (munajjim) is a liar because
he or she is trying to appropriate Allah’s prerogative of knowing
the unseen (ghaib)
(p 755 7:131, 27:47, 36:18-19)