1. 9906-ISLAMIC MEDICINE: ITS MEANING AND PRINCIPLESLecture to 1st year medical students at the Kulliyah of Medicine, International Islamic University, Kuantan on 19th June 1999by Prof Dr Omar Hasan Kasule, Sr.1.0 DEFINITION OF ISLAMIC MEDICINE: A PROBLEMThe concept of Islamic Medicine is still elusive after more than 2 decades of inquiry about the matter. It has meant many things to different people. The 1st International Conference on International Medicine held in Kuwaitdebated two approaches to the definition: (a) concept of revival of ancient Muslim medicine and the (b) the concept of applying Islamic values and paradigms to any type of medicine thereby Islamising it (52). Subsequent seminars and publications in Kuwait delved deeper into the issue (44, 45, 46). Two seminars were held in Malaysia with the involvement of the Islamic Medical Association of Malaysia to debate the issue in July 1995 and 1997 (52, 33). We will review various views of Islamic medicine and conclude by giving what we feel is the most appropriate definition. 2.0 TRADITIONAL OR ALTERNATIVE MEDICINEThe debate on the definition of Islamic medicine has been blown off course in 2 unhealthy ways. Some persons who have no medical training have claimed to practise the so-called Islamic medicine as an alternative to western medicine. The Islamic sentiments of the masses as well as disenchantment with systems of medical care have turned many towards this alternative form of medicine. Our experience with practitioners of this medicine is that they are are pursuing narrow interests. Not only do they provide medicine and other forms of physical therapy buy they also sometimes get involved in superstitious practices that contradict the tauhidi creed of Islam. A second way in which this debate has become unhealthy is when it is politicised and it becomes an issue of cultural or ‘medical’ nationalism, both concepts being alien to Islam. The argument goes like this: if westerners have scientific medicine provided at government hospitals, then Africans or other ethnicities should also have their own traditional medicine that must be defended against the encroachment of western medicine. Islam came to break down barriers of prejudice and build one universal brotherhood under which all parochial interests would be buried. Islam therefore does not accept a dichotomy in medicine depending on who developed it. All medicine is judged on its usefulness, effectiveness, and lack of harmful effects. All effective and useful medical systems either in toto or in parts are accepted by Muslims and they are loathe to attach nationalistic labels to them. 3.0 MEDICINE OF THE EARLY MUSLIM SOCIETYStarting with the advent of the 15th century of hegira that coincided with major political and social upheavels in the ummat (Iranian revolution, Afghan jihad, islamisation in Pakistan under the late Zia al Haqq), there was increased pride in the achievements of the Islamic civilisation in all fields including medicine. A major proportion of the papers at the 1st and 2nd International Conferences on Islamic Medicine in Kuwait in 1981 and 1982 respectively was devoted to history (6). Special seminars either free-standing or as part of medical conferences have been devoted to the memory of early Muslim physicians such as Ibn Nafees, al Zahrawi, and others (6,18). Some of the authors demand justice for Muslim contribution to western medicine that the west has ignored (14, 63, 64, 70). Some claims of early Muslim contributions are exaggerated such as saying that al Zahrawi was the first surgeon in the world (21). The medicine practised by Muslims in the golden era of Islamic civilization has been looked at by some as the ideal of Islamic medicine. Islamic medicine was defined by Syed Hosein Nasr and others (16, 64) as the historical achievements. The historical theme has continues to fascinate all Muslim physicians who write on Islamic medicine and reading through their literature one is drawn to the inevitable conclusion that history is both an inspiration and a challenge to the present generation (14). Arguments have been advanced that the historical perpsective can not on its own define an Islamic paradigm of medicine (52). It could actually be utilised in a negative way as a psychological defense mechanism to rationalise failure of the contemporary generation to achieve what the ancients did. It is also an issue open to debate whether all what was achieved historically can be termed Islamic medicine. Humans and circumstances were not always in conformity with the broad vision of Islam. The ownership of such medicine is also debatable. Muslims learned it from the Greeks and they improved it. In India they did not even change its name and continued calling it tibb unani (Arabic for Greek medicine). Claiming that such medicine represents the Islamic ideal in medicine can therefore not be supported. There have been efforts to revive traditional Muslim medicine in a new form by carrying out scientific studies including double-blind controlled clinical studies to show its therapeutic effectiveness and also study other aspects relating to its pharmacology. The 1st and 2nd International Conferences on Islamic Medicine devoted a lot of time to revival of old remedies with a lot of optimism for the future (6). The Hamdard Foundation inPakistan in engaged in research on traditional herbal remedies. However these efforts have not been pursued vigorously and consistently in other countries. 4.0 QUR’ANIC AND PROPHETIC MEDICINE: The Qur’an and sunnat have many teachings on medicine either general or specific (19, 29, 30,31, 66, 67). The Qur’an is itself a cure and there is a definite role for spiritual cures in the medical scheme (6). The relevance of Qur’anic and hadith guidance on medicine and health to the modern situation has been a major pre-occupation. Some authors have prescribed preventive and curative measures from the teachings of the Qur’an and thesunnat of the Prophet (1,2, 48, 71). Preventive medicine has in particular been associated with Islamic medicine (47). There have been attempts to reconcile medical teachings of the Qur’an and sunnat with modern findings by medical science (17, 61, 66). Clinical and other studies have been carried out about medical teachings in thesunnat to prove their efficacy. The black seed is the most popular in this regard (57). While tibb Qur’anu andtibb nabawi are a valid expression of Islamic medicine, they do not represent the total picture or cover the whole spectrum of Islamic medicine (52). 5.0 CRITERIA OF ISLAMIC MEDICINEAhmad El Kadhi presented a paper at the First International Conference on Islamic Medicine held in Kuwait in January 1980 (Athar 1993) and proposed 6 distinguishing criteria of Islamic medicine and using statistics and medical experience in the US 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, ie consistent and logical; (d) comprehensive, paying attention tot he body and the spirit, the individual and the society; (e) universal, utilizing all useful resources and offers its services to all mankind; (f) scientific. Two of the 6 criteria require a re-examination. Criterion (a) should not be taken in an absolute way. A medical system’s excellence or advancement is a relative assessment based on the knowledge and resources available at a particular time and 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 better be defined as based on objective research using all sources of knowledge available including revelation. The word ‘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. This is in addition to fraud and incompetence that are reported in the press. 6.0 VALUES AND ETHICS OF ISLAMIC MEDICINEUse of values and ethics as defining characteristics was seen as an improvement on the definition of Islamic Medicine using operational criteria. The criteria are difficult to measure and compare across different systems of medicine. Dr. Omar Hasan Kasule, Sr. in a paper presented to the first International Islamic Medicine Conference Kuwait (Kasule 1980) argued that Islamic medicine can be defined only as values 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. 5.0 WORKING DEFINITION OF ISLAMIC MEDICINEIt is clear from the above that there is a need for a clearer definition. Various perspectives of Islamic medicine have been explored critically and a synthesis is made ending with a proposal of a new definition below. A definition proposed by Kasule (52) for Islamic medicine could act as a working hypothesis until a finer definition evolves: Islamic medicine is defined as medicine whose basic paradigms, concepts, values, and procedures conform to or do not contradict the Qur’an and sunnat. 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 investigation and treatment of diseases within the framework described above’. REFERENCES Abdullah, Muhammad Mahmoud. [al Tibb fi al Qur'an wa al Sunnat Bayna Tashkhiis al Daa wa Ma'arfiat al Dawa]. Medicine in Qur'an and Sunnat Between Diagnosis and Treatment. Dar maktabat al tarbiyat. Beirut. ? dateAbdullah, Muhammad Mahmoud. [al Tibb al Qur'ani Bayna al Ghada'a wa al Dawa] Qur'anic Medicine Between Diet and Drugs. Muassasat Shabab al jamiat. Alexandria. ? DateAmod, Farouk. 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