Alhassanain(p) Network for Heritage and Islamic Thought

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Contribution of Islam to Medicine

Author:Ezzat Abouleish , M. D.

www.alhassanain.org/english

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This versionis published on behalf of www.alhassanain.org/english

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Table of Contents

Introduction 5

The Spread of Islam 6

Islam and the Promotion of Culture and Science 7

Medicine Before Islam 9

Manpower and hospitals 10

A. Manpower before Islam: 10

B. Hospitals Before Islam: 10

Characteristic Features of Hospitals in the Islamic Civilization 11

The Reasons for the High Standard of Islamic Hospitals 13

Specific Hospitals 15

1. In El-Sham 16

2. In Iraq and Persia: 17

3. In Egypt: 17

Method of Therapy in Islamic Medicine 19

Medical Ethics in Islam 20

I. Personal characters of the physician: 20

II. His obligation towards patients: 20

III. His obligation towards the community: 20

IV. His obligations towards his colleagues: 20

V. His obligations towards his assistants: 20

Islamic Physicians 21

AL-Razi (Razes) 841-926 A.D 22

AL-Zahrawi (ABULCASIS, BUCASIS, ALZAHRAVIUS) 930-1013 A.D 24

Ibn-Sina (AVICENNA) 980-1037 A.D 27

Ibn-El-Nafis 1208 - 1288 A.D 30

The Arabs And Ophthalmology 33

ARABS AND ANESTHESIA 34

ARABS AND OBSTETRICS 35

Introduction

Medicine, as it stands today, did not develop overnight. It is the culmination of efforts of millions of people, some weknow and others we do not. The flame of civilization, including medicine, started thousands of years ago. The flame has been handed over from one generation toanother, and from one country to the other.

Depending on who took the sacred responsibility of hosting it, sometimes it got brighter and sometimes it got dimmer. However, it never died away, because if it did, it would have been too hard to start all over again.

Between the ancient civilizations, namely the Egyptians, Greek, Roman, Persian, Indian, and Chinese, and the Renaissance era in Europe, there was a gap, commonly called "the dark ages", during which the flame was hosted, not by the West, but by another culture and people called the Arabs or the Moslems.

The nomenclature, "the dark ages" reflects the civilization in Europe between the 7th and 13th centuries, but by no means it expresses the state of affairs in the Arab world or the Islamic Empire at that time when an and science were as bright as the midday sun. That era,unjustifiably, has been commonly neglected andoverpassed , as if nothing happened . This paper is an effort toelude to the important events which took place and the significant physicians who lived during that period.

The Spread of Islam

In order to understand how medicine developed in themiddle ages , we have to look back at the history and find out the important things that happened during the Seventh Century.

In 570 A.D., a man was born in a small city in the Arabianpeninsula , called Mecca (Haykal 1976), his name was Mohammed. In 610A.D. he declared a new religion, Islam. In 632 A.D., he died after uniting the Arab tribes whohad been torn by revenge, rivalry, and internal fights. Out of these mostly illiterate nomadic people, he produced a strong nation that encountered and conquered, simultaneously, the two known empires at that time, namely, the Persian and Byzantine Empires.

In a man'slife-time , the Islamic Empire extended from the Atlantic Ocean on the West, to the borders of China on the East. In 711 A.D., only 80 years after the death of their prophet, the Arabs crossed to Europe to rule Spain for more than 700 years. In 732 A.D., they threatened Paris and their thrustwas stopped at Tours andPoiter (Eigeland 1976). In 831 A.D., the Moslems of North Africa invaded Sicily and ruled it for 200 years. By 846 A.D., they controlled the southern part of Italy and encountered Rome (Hitti 1977).

The hold of the Moslems over Italy remained so firm that Pope John VIII (872-882 A.D.) deemed it prudent to pay tribute for two years (Hitti 1977)In 869 A.D., the Arabs captured Malta (Ibn-Khaldun). In the tenth century, from Italy and Spain, the Arabs extended their raids through the Alpine passages into mid-Europe.

In the Alps, there are a number of castles andwalls which tourists guides attribute to the invasion of the Moslems of Sicily. In the southern part of Italy and in Sicily, a great civilization was established and through which the torch of knowledge spread to Europe, mainly through the University of Salerno in the southern part of Italy (Hitti 1977,Parente 1967).

The expansion of the Moslems in Europe was not limited to those from North Africa and Spain. The Moslems, under the Ottoman Empire, invaded Europe from the East. They occupied a good part of Middle Europe and besieged Vienna twice, once during the reign ofSulayman 1 (1520-1566 A.D.) and the other during the reign of Mohammed IV (1648-1687 A.D.)(Hitti 1977).

Islam and the Promotion of Culture and Science

As the Moslems challenged the civilized world at that time, they preserved the cultures of the conquered countries. On the other hand, when the Islamic Empire became weak, most of the Islamic contributions in art and sciencewere destroyed .This was done by the Mongols who, out of barbarism, burnt Baghdad (1258 A.D.), and by the Spaniards, who out of hatred, demolished most of the Arabic heritage in Spain . The difference between the Arabs and these was the teachings of Islam which:

1. Stressed the importance and respect of learning. For example, the first word revealed to the Moslems' prophet Mohammed was "Read". In Mohammed's era, a captured enemywas freed if he paid a ransom or taught ten Moslems writing and reading. In their holy book, the Qur'an, the importance of knowledge has been repeatedly stressed as itsays "Those who know and those who do not are not equal."

The prophet Mohammed stressed learning by saying. "One hour of teaching is better than a night of praying." One of the early princes, Khalidfbn Yazid (end of the 7th century), gave up his treasure for the study of medicine and chemistry. He studied medicine under John the Grammarian ofAlexandria, and chemistry underMerrinos the Greek (Haddad 1942). He also encouraged several Greek and Coptic medical books tobe translated into Arabic.

2. Forbade destruction. On conquering Mecca, the prophet Mohammed strongly stated that no homes, animals, or treesshould be destroyed . His followers abided with these principles when conquering other countries.

3. Encouraged cleanliness and personal hygiene. Islam instructed them to approach God in their prayers five times a day with bodies and clothes spotlessly clean.

4.Developed in them the respect of authority and discipline. For example, realizing the scourges and terror of plague, their prophet Mohammed (p.b.u.h .)decreed that "no man may enter or leave a town in which plague broke out."And to make this law all the more binding and effective, he promised the blessing of heaven to those who die of plague by stating that if a man died of plague he would be considered a martyr (Haddad 1942).Thus Mohammed (p.b.u.h .) laid for the Moslems the laws governingcorden and quarantine for the first time in history and made it work.

5. Tolerated other religions. The Islamic religion recognizes Christianity and Judaism and considers their followers to be people with holy books like Moslems. Moreover, they candidly treated the Jews at an era when the latterwere persecuted in Europe. Dr. JacobMinkin , a reputable Rabbi and scholarsays "It wasMohammadan Spain, the only land of freedom the Jews knew in nearly a thousand years of their dispersion...

While during the Crusades, the armored Knights of the Cross spread death and devastation in the Jewish communities of the countries through which they passed, Jews were safe under the sign of the Crescent. They were not only safe in life and possessions, butwere given the opportunity to live their own lives and develop a culture so unique and striking that it went down in history as the 'Golden Ages'. The Moors, the Muslim conquerors of Spain in 711, were not religious fanatics. They were strong in their faith but generous with regard to the religious convictions of others....

"TheRanaissance of Art inItaly, says George A. Dorsey, has blinded us to the Renaissance of Science in Spain, which fostered science, promoted culture, encouraged learning, and set a premium on intellectual pursuits, no matter whether the intellect was Moslem, Christian or Jew. Not since the days of Greece had the world known such thirst for knowledge, such passion for learning, such spirit shared by the prince and thecourtien alike" (Minkin 1968).

The Arabswere assimilated by the vast new countries they reached. From this marriage of genuine characters and righteousness with the ancient andwell established civilizations, a great new nation was born. It is difficult to identify this new breed as Arabs, because although the language was Arabic,all the scientists were not necessarily from the Arabian Peninsula.

It is also equally difficult to describe it as Islamic, because although the majority of the scientists were Moslems, sponsored by Moslem rulers, and governed by the Islamic law, yet some scientists were Christians or Jews, especially at the early phase of thelslamic civilization: the translation period to Arabic, and the decline part: the translation period to Latin and Hebrew. Therefore, in this article, the adjectives Arabic or Islamic will be used as synonyms.

MedicineBefore Islam

In order to comprehend the contributions of Arabs tomedicine,we must have in our minds a picture of the condition of medicine before they arrived to the scene.Generally speaking, two elements are required for medical practice:

Manpower and hospitals

A. Manpower before Islam:

There were medical centers in different parts of theworld which were later either under control of the Arabs or in touch with them. For example, in Syria, medicine was advanced and was greatly influenced by the Byzantinecivilization which affected also the economic and administrative systems (Hammameh 1962). From the fifth century on, the Greek was the language of learning in Syria. The knowledge of the Arabs of the Greek civilization was mainly through the Syrian scholars who translated it into Arabic.

In Egypt, Alexandria was another center for culture. The Arabs got in touch with both the ancient Egyptian and Greek civilizations through the Egyptian scholars.In Persia, there was a medical school in a city calledJundi-Shapur in which medicine was highly developed.

TheAbbasi Caliphs during the 8th century encouraged the Persian physicians to translate into Arabic the medical knowledge therein, to build medical centers in Baghdad, the capital of their empire, and to run newly built hospitals. With further expansion east, the Arabs through contacts with India and China, brought ideas and methods, not only in medicine, but also in mathematics, chemistry, philosophy, etc.

B. HospitalsBefore Islam:

Hospitals as we know them now probably were not present. True, there were places for the sick to stay, but these were mainly temples or annexes to temples thatwere run by priests. Gods were supposed to play a major role in the art of healing. For example, the GoddessToueris was the Egyptian symbol of fecundity andprotectress of the pregnant and parturient.

Shewas shown as a standing pregnant hippopotamus carrying thehicroglyph meaning protection in one paw, and the sign of life in the other. Small figures ofToucris were popular as amulets (Speert 1973). In those days, sanctuary, prayers,inactation , and hypnosis were integral parts of the therapy.

Characteristic Features of Hospitals in the Islamic Civilization

During the Islamic civilization, hospitals had much developed and attained specific characteristics:

1. Secular: Hospitals served all peoples irrespective of color, religion, or background. Theywere run by the government rather than by the church, and their Directors were commonly physicians assisted by persons who had no religious color. In hospitals, physicians of all faiths worked together with one aim in common: the well-being of patients.

2. Separate wards: Patients of different sexes occupied separate wards.Also different diseases especially infectious ones, were allocated different wards.

3. Separate nurses: Male nurses were to take care of male patients, and vice versa.

4. Baths and water supplies: Praying five times a day is an important pillar of Islam. Sick or healthy, it is an Islamic obligation; ofcourse physical performance depends on one's health, even he can pray while laying in bed. Before praying, washing of face, head, hands, and feetmust be done , if possible.For certain conditions , a bath is obligatory. Therefore, these hospitals had to provide the patients and employees with plentiful water supply and with bathing facilities.

5. Practicing physicians: Only qualified physicianswere allowed by law to practice medicine. In 931 A.D., the Caliph Al-Mugtadir from the Abbasid dynasty, ordered the Chief Court-PhysicianSinan Ibn-Thabit to screen the 860 physicians-of Baghdad, and only those qualifiedwere granted license to practice (Hamarneh 1962).

The counterpart ofIbn -Tbabit , Abu-Osman Sai'd Ibn-Yaqub was ordered to do the same in Damascus, Mecca, and Medina. The latter two cities were in need for such an act because of hundreds of thousands of pilgrims visiting them every year. This was to prevent taking advantage of these pilgrims and to curb the spread of diseases among them.

6. Rather medical schools: The hospital was not only a place for treating patients, but also for educating medical students, interchanging medical knowledge, and developing medicine as a whole. To the main hospitals, there were attached expensive libraries containing the most up-to-date books, auditoria for meetings and lectures, and housing for students and house-staff.

7.Proper records of patients: For the first time in history, these hospitals kept records of patients and their medical care.

8. Pharmacy: During the Islamic era, the science and the profession of pharmacy had developed to an outstanding degree. The Arabicmateria medica became so rich and new drugs and compounds were introduced because the Muslims had contact with almost all the known world at that time,either through control or trade . Their ships sailed to China and the Philippines, and their convoys made trades with black Africa,Europe and Asia. Chemistry became an advanced science, and there were means and need for a specialization called pharmacy.

Thus, the main Arabian hospitals were models for medieval hospitals built later in Europe. They were rather medical schools to which those seeking advanced medical knowledge, from the East or West, attended.

The Reasons for the High Standard of Islamic Hospitals

In the Islamic Empire, the hospitals attained a golden era unsurpassed in previous history. The reasons behind such a high standard include:

1. Being part of a civilization as awhole:The people were prosperous; thus, they were capable of taking care of their health and of seeking the best available treatment.Also ,lslam stresses the necessity of seeking treatment of every disease; the Prophet says "For every disease, God created a cure." The required sciences for good medical care were at a high standard e.g. the Arabswere advanced in chemistry, mathematics, administration, pharmacy, medicine, etc. They gave the world the system of numbering which have replaced the cumbersome Roman numerals.

The world owes to them the knowledge of the following chemical reactions, namely sublimation, precipitation, filtration, distillation, etc.The great.

Arab chemist JabirIbn -Hayan discoveredsulphuric and nitric acids. According to Webster Dictionary, the words sugar, alcohol, alkali, syrup, coffee, cotton, all are Arabic words. Fielding H. Garrison, the author of the well-known work on the "History of Medicine" said: "...The Saracens themselves were the originators not only of algebra, chemistry, and geology, but of many of the so- called improvements or refinements of civilization, such as street lamps, window-panes, firework, stringed instruments, cultivated fruits, perfumes, spices, etc... "

2. High prestige of physicians: The physicians in this era earned a high prestige. Although anyone, irrespective of his social status, can study medicine, yet the route was long and tedious. He had to finish Islamic studies, philosophy, astronomy, art, chemistry, etc. beforebeing accepted as a medical student. Therefore, the physician was a cultured person who had wisdom and knowledge. In fact, the Arabic translation of a physician is "Hakim" which means sage. In the 9th and 10th century, the Court- Physician was in the protocol ahead of theChief-Justice .

Many eminent physicians, as we will discuss later, showed enough talent, social knowledge, political capabilities, and wisdom to be appointed by the Caliphs asprime ministers (Visiers ). Owing to the high prestige and connections of physicians, generous funds for hospitalswere easily obtained .

3. Rulers' involvement in public services: The Caliphs of the Islamic empire built magnificent hospitals for one or more of the following reasons:

a. Religion: Their religion stated that money spent on charity is a good investment for Judgment Day.

b. Eternity: ThePharoahs of Ancient Egypt sought eternity by buildingpyramids, the rulers of Islam sought the same thing by building mosques, hospitals, and schools carrying their names.

c. Politics: To show their people that they cared, and were interested in them, the rulers built hospitals.

Whatever the motive of the ruler, the population benefited and good hospitalswere erected .

4. Adequate financing to run thehospitals:The rulers set aside generous funds to run these hospitals.Also the philanthropists gave generously, thus following their religious beliefs and imitating their rulers. In Islam, there is a special system called Al-Waqf . A person can donate part or all of this wealth to charity.

The government takes care of such a donation, and its revenues help to maintain and build mosques, hospitals, and schools. Another source of funds and an important pillar of Islam is alms-giving (2 1/2% of property value). Collected almsgoes to the state treasury which takes care of charitable organizations. Very few hospitals in the Islamic era were private. Thus,patients fees constituted an unimportant source of funding.

Specific Hospitals

The capital of the Islamic empire kept changing from one dynasty to the other. In each capital, an important medical center developed. Thus, by the end of the 13th century, there were many medical centers spread throughout the Arab world. Space does not allow the description of all the hospitals built throughout these centuries. We, therefore, chose some of the importantones which will be described according to the region where they were developed.

1.In El-Sham

El-Sham at that time included what is known now as Syria, Lebanon, Jordan, and Palestine,Damascus and Jerusalem were the important cities.

a . In Damascus: The first known hospital in Islam was built in Damascus in 706 A.D. by the Umayyad Caliph, Al-Walid (Hamarneh 1962). The most important hospital built in Damascus in the middle ages was named Al-Nuri Hospital, after KingNur Al-DinZinki , in 1 156. This hospitalwas built during the Crusade Wars to fulfill a need for a well-equipped and well-staffed hospital. It turned out to be not only a first class hospital, but also a first class medical school.

The king donated to the hospital a whole library rich in medical books. It is important to understand why books were expensive and limited in number in the middle ages. This was because they were hand-written as printing was not used until the middle of the fifteenth century. The hospital adopted medical records, probably the firstfirst in history. From its medical school, many eminent physicians graduated, an example isIbn Al-Nafis , the scholar who discovered the pulmonary circulation as will be discussed. The hospital served the people for seven centuries and parts of it still exist.

b . In Jerusalem: In 1055 A.D., the Crusaders built Saint John Hospital. By the end of the eleventh century, it grew to such an extent to include a hospital, a palace for knights, and a convent for the nursing sisters. The medical activities of the hospital were tremendous because of the large number of daily admissions of patients, pilgrims, and wounded soldiers. After the liberation of Jerusalem bySalah Al-Din in 1187 A.D., the hospital namewas changed into Al-Salahani Hopital . He expanded thehospital which continued to serve the people until its destruction by an earthquake in 1458 A.D.

2.In Iraq and Persia:

In 750 A.D.,Baghdad was built to be the capital of the Abbasid dynasty by theCalip Abu-Gaifar Al- Mansur . In 766 A.D., he assigned the dean of the medical school ofJindi Shapur ,Judis Ibn-Babtishu ', to be the Court- Physician and to establish hospitals proportionate to the glory and prosperity of Baghdad.

WhenHarun Al-Rashid followed (786-809 A.D.), he ordered the grandson ofIbn-Bahtishu and his Court-Physician,Jibril , to build a special hospital named Baghdad Hospital. This hospital developed into an important medic center. One of its chiefs was Al-Razi , the eminent Internist.

In 918 A.D., the Caliph Al-Mugtadir built two hospitals in Baghdad. One was on the east side of thecity which he named Al-Sayyidah Hospital, after his mother. The other was on the westside which he named, Al-Mugtadiri Hospital, after himself.

Another important hospitalwas named Al-Adudi Hospital. Itwas built in 981 A.D. after KingAdud Al-Dawlah . It was the most magnificent hospital built in Baghdad before modern time. The Caliph wanted to outdo his predecessors. Itwas furnished with the best equipment and supplies known at the time. It had interns, residents, and 24 consultants attending its professional activities.Haly Abbas , who wrote the famous book "Liber Regius (Al-Malaki )", was one of the staff. Itwas destroyed in 1258 when the Mongols, led byHolagu the grandson ofGhingiz Khan, invaded Baghdad.

3.In Egypt:

In 872 A.D., AhmedIbn-Tulun built a hospital called Al-Fusta Hospital in the City Al-Fustat which is now in old Cairo. It served the growing Cairo population for six centuries. Itwas divided into separate wards. On admission, the patientswere given special apparel while their clothes, money, and valuables were stored until the time of their discharge.

In 1284 A.D., King Al-MansurQalawun built an important hospital named Al-MansuriHospital . The story behind its construction is interesting. King Al-MansurQalawun was an officer in the Arabian army fighting the Crusaders. While in the Holy Land, he fell sick andwas admitted to Al-Nuri Hospital.

On recovery, he vowed that if he ever became the ruler of Egypt, he would build a great hospital in Cairo even more magnificent than Al-Nuri Hospital for, the sick.poor , and rich alike. At the dedication ceremony, he asked for a cup of wine from the pharmacy. After drinkingit he declared that by taking that portion as a medication, he was signifying that the hospital was serving all people.from the king to the least of his subjects (Hamarneh 1962).

e. It was the best hospital built then as reported by the contemporary historians such asIbn-Battota and El-Kalkashandi . It had different sections for different diseases. Music therapywas used as a line of treatment for psychiatric patients. It served 4,000 patients daily. The patient's stay in the hospital was free moreover on hisdischarge, the patient was given food and money for compensation for being out of work during his hospital stay. Al-Mansuri Hospital has served Cairo for seven centuries since ithas been built . Itis now used for ophthalmology and calledMustashfa Qalawun . Its ancient dooris preserved in the Islamic Museum of Cairo.

4.In North Africa (Al-Maghrib Al-Arabi ):

a. Tunisia: In 830 A.D., PrinceZiyadat AllahI, built Al-Qayrawan Hospital in a district of theQayrawan city called Al-Dimnah . Subsequently all hospitals in Tunisia were calledDimnah instead ofBimaristan as they were called in the East, which is a Persian word meaning a hospital.TheQayrawan Hospital was characterized by spacious separate wards waiting rooms for visitors and patients, and female nurses from Sudan, an event representing the first use of nursing in Arabic history. The hospital also included a chapel for prayers.

b. Morocco: In 1190 A.D., the king Al-MansurYa'qub Ibn -Yusuf, built a hospital in the capital city,Marakesh , named it theMarakesh Hospital. It was a huge hospital beautifully landscaped with fruit trees and flowers.Water was brought by aqueducts to all sections . Patientswere provided with special apparel: one for winter and another for summer. The pharmacywas taken care of by specialists called theSayadlah . There was an expensive private section where a patientwas charged what is equivalent to $ 1501 day. One thousand years ago, this fee was quite expensive.

5. Al-Andalus (Spain):

In 1366 A.D., PrinceMuhammed Ibn -YusufIbn Nasr, built the Granada Hospital in the city of Granada which had expanded to half a million population. The hospital represented the beauty of the Arabic architecture in Spain and served the people until the fall of Granada in 1492 A.D.

Method of Therapy in Islamic Medicine

The patientswere treated through a scheme starting with physiotherapy and diet; if this failed, drugs were used, and at last, surgery would be resorted to. The physiotherapy included exercises and water baths. The Arabs had an elaborate system of dieting and were aware of food deficiencies. Proper nutrition was an important item of treatment.

Drugswere divided into two groups: simple and compound drugs. They were aware of the interaction between drugs; thus, they used simple drugs first. If these failed, compound drugs were used which are made from two or more compounds. If these conservative measures failed, surgery was undertaken.

Medical Ethics in Islam

The medical profession was awell respected specialty and itsIeaders kept it this way by laying down proper ethics. Al-Tabari , the chief physician in 970 A.D., described the Islamic code of ethics as follows (Hamamch 1971, Levy 1967):

I. Personal characters of the physician:

The Physician ought to be modest, virtuous, merciful, andun addicted to liquor. He should wear clean clothes, be dignified, and have well- groomed hair and beard. He should not join the ungodly andscaffers , nor sit at their table. He should select his company to be persons of good reputation. He should be careful of what he says and should not hesitate to ask forgiveness if he has made an error. He should be forgiving and never seek revenge. He should be friendly and peacemaker. He should not make jokes or laugh at the improper time or place.

II. His obligation towards patients:

He should avoid predicting whether a patient will live ordie, only God (Allah) knows. He oughtnot loose his temper when his patient keeps asking questions, but should answer gently and compassionately. He should treat alike the rich and the poor, the master and the servant, the powerful and the powerless, the elite and the illiterate. God will reward him if he helps the needy. The physician should not be late for his rounds or his house calls. He should be punctual and reliable.

He should not wrangle about his fees. If the patient is very ill or in an emergency, he should be thankful, no matter how much he is paid. He should not give drugs to a pregnant woman for an abortion unless necessary for the mother's health. If the physician prescribes a drug orally, he should make sure that the patient understands the name correctly, in case he would ask for the wrong drug and get worse instead of better. He should be decent towards women and should not divulge the secrets of his patients.

III. His obligation towards the community:

The physician should speak no evil of reputable men of the community or be critical of any one's religious belief.

IV. His obligations towards his colleagues:

The physician should speak well of his acquaintances and colleagues. He should not honor himself by shaming others. If another physicianhas been called to treat his patient, the family doctor should not criticize his colleague even if the diagnosis and the recommendations of the latter differ from his own. However, be has the obligation to explain what each point of view may lead to since his duty is to counsel the patient as best as he can. He must warn him that combining different types of therapy may be dangerous because the actions of different drugs may be incompatible and injurious.

V. His obligations towards his assistants:

If his subordinate does wrong, the physician should not rebuke him in front of others, but privately and cordially.

Islamic Physicians

Medicine in Islam passed through three stages:

I. The first stage is the stage of translation of foreign sources into Arabic. It extended mainly during the seventh and eighth centuries. II. The second stage is the stage of excellence and genuine contribution in which the Islamic physicians were the leaders and the source of new chapters to medicine. This stage extended during the ninth through the thirteenth centuries.

III. The third stage is the stage of decline where medicine, as well as other branches of science, became stagnant and deteriorated. The stage started mainly after the thirteenth century.

During the first stage, Syrian and Persian scholars did a marvelous job by translating honestly the ancient literature from Greek andSyriac in Arabic.Thcy translated different branches of science including philosophy astrology, and medicine. The works ofHippocratcs (460-370 BC),Aristototle (384-322 BC), and Galen (131-210 A.D.) were among those translated From Arabic, the classic Greek literaturewas translated into Latin, then into Greek because most of the original scripts were lost and the only source was the Arabic translation.

If the Arabs did only one thing, namely, preserving the ancient literature and handing it honestly to Europe, that would have been a sufficient contribution in itself. The Moslem rulers encouraged translation, e.g.Khalif Al-Mamun Al-Abbassi paid the translator the weight of his translation in gold (Haddad 1942). Among the eminent physicians who took part in the first stage wereJurjis lbn-Bakhtisliu , his grandsonJibril ,Yuhanna Ibn-Masawaya , andHunain Ibn-Ishak ; most of them were Christians, yet they were respected and well treated by the Moslem rulers.

It is said, rightly or wrongly, that the history of a nation is the sum total of the history of a few of its individuals.Ths is particularly true in the history of medicine during the Arab period. In every stage of its development we find men of outstanding repute, the sum total of whose efforts has constituted this magnificent chapter. It is impossible to give an account of all the important physicians ofIslwn .

We thus are going to discuss some of those who were known to Medieval Europe and whose books affected its thinking and practice for centuries (Table 1), I chose an internist, Al-Razi (Razes); a surgeon, Al-Zahrawi (Abulcasis ); the physician-philosopher of Islam,Ibn-Sina (Avicenna); the philosopher-physician of Islam,Ibn-Rushd (Averroes); a pioneer in physiology,Ibn -Al-Nafis ; and a Jewish Arab,Ibn -Maimon (Maimonides).

AL-Razi (Razes) 841-926 A.D.

His full name is Abu-BakrMohammaed Ibn-Zakaria Al-Razi , known to the Western World as Razes. He was born in Ray, a suburb of Tehran, the capital of modern Persia (Profile of Iran 1977,Sarton 1950). He first studiedmusic which was his main interest in his early life. He was a skillful player on the lute. He then studied philosophy, and later medicine. But he was a better physician than aphilosopher ,

He first became the Court-Physician of Prince AbuSaleh Al-Mansur, the ruler ofKhorosan . Then he moved to Baghdad where he became the Chief Physician of the Baghdad Hospital and the Court-Physician of the Caliph. He had a good basis of physics and chemistry as well as medicine.

He published severalbooks which were translated into Latin, French, Italian, Hebrew, and Greek. One of his main books is "Al-Mansuri " (Liber Al-Mansofis ) which he dedicated to his patron Prince Al-Mansur. It was composed of ten treatises and included all aspects of health and disease. He defined medicine as "the art concerned in preserving healthy bodies, in combating disease, and in restoring health to the sick." He thus showed the three aspects of medicine namely, public health, preventive medicine, and treatment of specific diseases.he listed seven principles for the preservation of health:

1. Moderation and balance in motion and rest.

2. Moderation in eating and drinking.

3. Elimination of superfluities.

4. Improvement and regulation of dwelling places.

5. Avoidance of excessive evil happenings before they become uncontrollable.

6. Maintenance of harmony in ambitions and resolutions.

7. Acquisition of reticence through possession of good habits including exercise.

He also published another book called "Al-Murshid ". In it, he emphasized the important lines of therapy that we mentioned earlier. He described the different types of fever including continuous, relapsing, and hectic. He stated that fever can be a symptom of a disease or a disease in itself. He introduced mercury as a therapeutic drug for the first time in history, whichwas later adopted in Europe. He realized that a man normally does not want to get sick, and he wants to recover as soon as possible.

However, if a patient does not have the will or the desire to get well, the physician's handsare tied and cannot help him. He stressed the continued medical education of the physician. He advised him to record his own observations. He encouraged him to meet with other physicians to discuss medical problems. He recommended that the physicians should try solving these problems rather than depending on others for finding solutions.

Another book written by Al-Razi was named "Al-Hawi ", which means the complete text. It was composed of 22 volumes. It was one of the maintext books in the medical school in Paris, especially its 9th volume on pharmacology.

He wrote a treatise on measles and smallpox called "dePeste or dePestilentia " which was translated to Latin in 1565 A.D. It is a masterpiece in clinical medicine (Browne 1962). It describes the clinical difference between the two diseases so vividly that nothing since has been added (Keys 1971).

Construction of Mosque Near The Graves of Pious People

Is construction of mosque near or in front of the grave of pious people permissible or not? Supposing it is permitted, then what is the main purpose of the tradition (hadith) of the Holy Prophet (s) regarding the actions of Jews and Christians as it has come in a tradition that the Holy Prophet (s) has cursed these two groups for considering the graves of their Prophets as objects of worship? Moreover, is construction of mosque near the graves of the Awliya inseparable with what has come down in this tradition!?

Answer: By paying attention to the general principles of Islam, construction of mosques, in the vicinity of graves of the awliya and pious d oesn’t not have the least problem. This is because the purpose of construction of mosque is nothing more than worshipping Allah near the grave of His beloved who has become the source of receiving gifts. In other words, the aim of establishing mosque in these instances is that the visitors to the Divine leaders either before or after their ziyarat, perform their duty of worship (‘ibadat) over there in as much as neither ziyara to graves is forbidden (even from the viewpoint of Wahhabis) nor performing of salat, after or before ziyarat. Therefore, there is no reason to believe that the construction of mosque near the graves of awliya for the purpose of worshipping Allah and performing divine duties is forbidden.

By paying attention to the story of Ashab al-Kahf it is deduced that this action was a custom prevalent in the previous religions and Qur’an has narrated that without any criticism. When the incident of Companions of Kahf was disclosed to the people of that time after 309 years, they expressed their views about the ways of honouring the Companions of Kahf. One group said that a structure should be made over their grave (so that apart from honouring them their names, signs and memories are kept alive). Qur’an expresses this view as such:

    فَقالُوا ابْنُوا عَلَيْهِمْ بُنْيَانًا

“…..Erect an edifice over them…., (Kahf 18:21)”

Another group said that a mosque should be built over their grave (and in this way tabarruk sought). The Islamic commentators are unanimous in their views.1 that the suggestion of the first group was related to the polytheists and the suggestion of the second group was that of the monotheists. The Qur’an, while narrating this saying, says:

    قَالَ الَّذِينَ غَلَبُوا عَلَىٰ أَمْرِهِمْ لَنَتَّخِذَنَّ عَلَيْهِمْ مَسْجِدًا

Those who prevailed in their affair said: We will certainly raise a masjid over them. (Kahf 18:21)2

History has it that the period of occurrence of the incidence of Companions of Kahf was the period of victory of monotheism over polytheism. There was no more of the sovereignty of the polytheists, nor their calling the people towards idol-worshipping. Naturally, this victorious group will be the same monotheist group, especially, that the content of their suggestion was the matter of construction of mosque for the sake of worshipping Allah. This itself is a witness that those making the suggestion were monotheists and God-worshippers.

If really the construction of mosque over or near the grave of the holy persons is a sin or polytheism, then why the monotheists made such a suggestion and why Qur’an narrates this without any criticism? Is not the narration of Qur’an together with this silence a testimony upon its permissibility? It is never proper that God narrates the sign of polytheism from a group but without specifically or implicitly criticising them. And this reasoning is the same ‘assertion’ which has been explained in ‘ilm al-‘usul. (Methodology)

This event shows that it has been one kind of lasting conduct amongst all the monotheists and was one way of honouring the one in grave or a means of seeking tabarruk.

It was reasonable and polite of the Wahhabis that before arguing about hadith, they should first have sought the reference from the Holy Qur’an and then attempted the analysis of the tradition.

Now we shall discuss and examine their reasonings.

Reasoning Of Wahhabis That Construction Of Mosque Near Grave Is Forbidden

By presenting a series of traditions, the Wahhabis have analysed the matter of construction of mosque near the grave of pious people to be forbidden. We shall examine all such traditions:

Bukhari in his Sahih under the chapter ofيكره من إنخاذ المساجد على القبور narrates two traditions as such:

    لما مات الحسن بن الحسن بن عليّ ضربَت إمراته القُبة عل قبره سنة ثم رفعت فسمعوا صائحاً يقول الأهل وجدوا

    ما فقدوا فاجابه الأخر بل يئسوا فانقلبوا

1. When al-Hasan bin al-Hasan bin ‘Ali passed away his wife made a dome (a tent) over his grave and after one year she removed it. It was heard that one person cried out: “Have they found that which they had lost”, another person replied: “No they have become disappointed and have given up.”

    لعن الله اليهود والنَّصار إتخذوا قبور انبيائهم مسجداً قالت (عائشة) ولولا ذلك لابرزُوا قبره غير أنَّي أخش أن يُتخذ مسجداً

2. May the curse of Allah be upon the Jews and Christians (for) considering the graves of their Prophets as mosques. She (Ayesha) said: “If it was not for this fear that the grave of the Holy Prophet (s) would become a mosque, the Muslims would have kept his grave open (and not put up a barrier around it).

3. Muslim has narrated in Sahih the same tradition with slight variation. As such we confine ourselves to narrating only one text.3

    ألا وإن من كان قبلكم كانُ,ا يتَّخذون قبور أنبيائهم وصالِحيهم مساجد ألا فلا تتخذوا القُبور مساجد إنى أنهاكُم عن ذلك

Know that people before you took the graves of their Prophets and the pious people as mosques. Never take the graves as mosques, I forbid you from that.4

    إن أُم حبيبة وأم سلمة ذكرتنا كنيسة رأيتها بالحبشة فيها تصاوير لرسول الله (صلى الله عليه وأله) فقال رسول الله

    إن أولئك إذا كان فيهم الرجُل الصالح فما بنوا على قبره مسجداً وصوَّروا فيه تلك الصُور أولئك شرار الخلق عند

    الله يوم القيامة .

4. Umm Habiba and Umm Salama (Wives of the Holy Prophet) saw a prophet's picture in the country of Ethiopia (when they had travelled to that place along with a group). The Holy Prophet (s) said: They are such people that whenever a pious man dies amongst them they construct a mosque over his grave and draw his picture on it. They are the worst of the people before God on the Day of Judgement.5

al-Nasa’i narrates from Ibn ‘Abbas in his Sunan under the chapter:

    التغليط في اتخاذ السُرج على القبور

as such:

    لعن الرسول زائرات القبور والمُتخذين عليها المساجد والسُرج

5. The Holy Prophet (s) has cursed those ladies who visit the grave and those who take them as mosques and light a lamp over it.6

Ibn Taymiyya who is the leader of such beliefs and Muhammad ibn ’Abd al-Wahhab sharing his views interpret the aforesaid traditions in such a manner that building mosque over or near the grave of pious people is not permitted.

Thus Ibn-Taymiyya writes:

    قال عُلمائنا لا يجوز بناء المسجد على القبور

“Our scholars have said that it is never allowed to construct a mosque over the grave.”7

A Probe into The Context of Traditions

Now we have to pay attention to the contents of the traditions and derive its correct meanings. We should not remain negligent to this principle and it is as such: As one verse (ayah) can remove the ambiguity of another verse and help its correct interpretation, in the same way, one tradition too can remove the ambiguity and interpret another tradition.

The Wahhabis have stuck to the apparent meaning of one tradition and relied on that in such a manner that any kind of building of mosque over or near the graves of awliya is prohibited whereas if they would have collected all the traditions together, they would have understood the objective of the Holy Prophet (s) in sending this curse.

The Wahhabis have closed the door of ijtihad and thus committed too many mistakes in understanding many of the traditions.

Superficially, it is possible that the authenticity of the traditions be reliable and its narrators trustworthy. Since the deliberation on the references of these traditions will lengthen our discussion, we shall limit ourselves to their contents only.

Our Views about This Matter

Awareness about the objective of the traditions is related to throwing light on the actions of the Jews and Christians near the graves of their respective Prophets because our Holy Prophet (s) has prevented us from the actions which they used to do. If the limits of their actions are clarified, then surely the limits of haram in Islam too would be clarified.

In the previous traditions there exist evidences which testified to the fact that they took the graves of their prophets as their qibla and refused from paying heed to the true qibla. More still, they were worshipping their prophets near their graves instead of worshipping Allah or at least were taking partners with God in their worship.

If the context of the traditions is this that we do not choose their graves to be their qibla and do not consider them as partners with God in worship, then we can never consider the construction of mosque over or near the graves of the pious and virtuous as haram where the visitors neither take their graves to be as their qibla nor do they worship them. Moreover, they worship the one God facing the qibla in their salat and the aim of constructing mosque near the graves of awliya Allah is only to seek tabarruk from their places.

What is important is that it should be proved that the aim of the tradition (that we should not take their graves as mosques) is the same as what we have just said. Here are the evidences:

1. The tradition of Sahih Muslim (4th tradition) elucidates the other traditions because when the two wives of the Holy Prophet (s) explained to him that they had seen a portrait of a Prophet in a Ethiopian church, the Holy Prophet (s) said:

“They are such people that whenever a pious person passes away they would construct a mosque over his grave and put up his portrait in that mosque.”8

The purpose of putting portraits near the graves of pious people was that people would worship them such that they considered the portrait and grave to be their qibla or still more, consider them as idols for worship and prostration. Worshipping of idols is nothing but placing the idol in front and respecting and falling into humiliation before them.

The probability which we are having in this tradition, keeping in mind the actions of the Christians who were and are always inclined towards human worship and are always worshipping portraits and statues, is very worthy of attention. With such strong probability we can never rationalize with the help of this tradition, the prohibition of construction of mosque over or near the grave of awliya Allah which is devoid of such embellishments.

2. Ahmad ibn Hanbal in his al-Musnad and Imam Malik in his al-Muwatta’ narrate the tradition that the Holy Prophet (s) after prohibiting the matter of construction of mosque said:

“Allah, do not make my grave as an idol which is subject to worship”9

This sentence shows that they were behaving with the grave and the portrait which was next to it like one idol and taking them as their qibla and still more is worshipping them in the form of idol.

3. Pondering over the tradition of Ayesha (2nd tradition) will elucidate this fact to a greater extent. After narrating the tradition from the Holy Prophet (s) she says:

“If it was not for the fear that the grave of the Holy Prophet (s) would be taken as mosque the Muslims would have kept his grave open”. (They would have not constructed a barrier around the grave)

Now it should be seen that from what aspects the barrier and wall around the grave can become an obstacle? Undoubtedly the barrier will prevent the people from reciting salat over the grave, from worshipping the grave as one idol or at least from taking it as a qibla. However, performing salat near the grave without worshipping the grave or considering it as a qibla is absolutely possible, whether there exists a barrier or not and whether the grave is open or hidden. This is because for fourteen centuries the Muslims have been performing salat near the grave of the Holy Prophet (s) facing the qibla and have been worshipping Allah without the barrier preventing them from doing this action.

To sum up, the appendix of the hadith which is the text of the sayings of Ayesha clarifies the contents of the tradition because Umm al-mu’minin says: ‘In order that the grave of the Holy Prophet (s) would not be taken as mosque, they kept his grave hidden from the eyes of the people and constructed a barrier around it.’ Now it should be seen as to what extent this barrier can serve as an obstacle.

A barrier can prevent from two things:

1. The grave from taking the shape of idol and the people from standing in front of it and worshipping it since with the presence of a barrier, people are unable to see his grave to be able to treat it as an idol.

2. The grave from becoming a qibla since fixing it as a qibla is the outcome of seeing and we can never compare it with the ka’ba which is a qibla in all the situations whether it is seen or not. This is because ka’ba is a universal conventional qibla in all the conditions, making no difference if it is seen or not. However taking the grave of the Holy Prophet (s) as a qibla for the attendants in the mosque will be related to those who offer salat in his mosque and such a deviation is more achievable in case the grave is uncovered and seen; but when the grave is concealed the thought of prostrating over his grave even in the form of qibla is much less. Due to this, Umm al-mu’minin says that if no possibility existed for considering the grave as mosque (ie. prostrating over the grave) it would have been kept uncovered. Moreover, such a deviation takes place more when the grave is seen and much less when the grave is hidden.

3. Most of the commentators of the tradition offer the same interpretation as we have done.

Al-Qastallani in Irshad al-sari says: For keeping alive the memories of their past ones, the Jews and Christians were fixing the portraits of their virtous ones near their graves and worshipping their graves. However, their sons and successors, under the influence of whisperings of shaytan, started to worship the portraits near the graves. Thereafter he narrates from Tafsir al-Baydawi as follows:

    لما كانت اليهود والنصارى يسجدون لقبور الأنبياء تعظيماً لشأنهم ويجعلونها قبلة يتوجهون في الصلاة نحوها

    واتخذوها اوثاناً ، مُنِع المسلمون في مثل ذلك فاما من إتخذ مسجداً في جوار صالح وقصد التبرك بالقُرب منه لا

    للتعظيم ولا للتوجيه إليه فلا يدخل في الوعيد المذكور .

“In view of the fact that the Jews and Christians were taking the graves of their Prophets as their qibla for the purpose of respect, and were paying attention towards them at the time of their prayers, their graves took the position of idols. For this reason the Muslims have been forbidden from this action. However, if someone constructs a mosque near the grave of a pious person for the purpose of seeking tabarruk and not for worshipping or paying attention towards them, he will never be included in this prohibition.”10

It is not only al-Qastallani who in his commentary on Sahih Bukhari interprets this tradition as such but also al-Sindi, the commentator of Sunan al-Nasa’i speaks with the same effect. We mention some of them here.

    إتخذوا قبور انبيائهم مساجد أي قبلة للصلاة ويُصلون إليها أو بنوا مساجد عليها يُصلون فيها ولعلَّ وجه الكراهة

    أنه قد يُفض إلى عباده نفس القبر .

“The outcome of his dispensation is this that construction over the grave is haram and occasionally makruh. If the grave is considered as qibla it is haram, since it may lead to the worship of the one buried, otherwise it is makruh.”11

Again he says:

    يُحذر أمته أن يصنعوا بقبره ما صنع اليهود والنصارى بقبور أنبيائهم من إتخاذهم تلك القبور مساجد إما بالسجود

    إليها تعظيماً لها أو يجعلها قبلة يتوجهون في الصلاة إليها .

“He (i.e. the Holy Prophet) prohibits his ummah from treating his grave in the same manner as what the Jews and the Christians have done to the graves of their Prophets. This is because, in the name of honor and respect, they were prostrating over the grave or considering it as their qibla.”12

Regarding this matter, the commentator of Sahih Muslim says:

“If the Holy Prophet (s) has prohibited us from considering his grave and other graves as a mosque, it is due to this reason that the Muslims should stop from exaggerating his honour which might lead to infidelity. Thus, when the Muslims were compelled to develop the mosque of the Holy Prophet (s) and place the chamber of the prophet’s wives and the chamber of Ayesha in the middle of the mosque, they fixed a round wall around the grave so that it could not be seen and the Muslims would not prostrate over it. The speech of Umm al-mu’minin too is a witness to the same:

    لولا ذلك لأبرزوا قبره غير أنه اخش أن يُتخذ مسجداً

If it was not for this fear that his grave (i.e. the grave of Holy Prophet) would become a mosque, the Muslims would have kept his grave open (and not put up a barrier around it).

Another commentator says: “The words of Ayesha are related to that period when the mosque was not developed nor extended. After extension and the admittance of her chamber inside the mosque, the chamber was made in the shape of a triangle so that nobody could perform salat over the grave. Thereafter he says that the Jews and Christians were worshipping their Prophets near their graves and were taking them as partners in their worship. With such evidence and perception of the tradition, one cannot understand any meaning other than this.”

We shall now overlook all these evidences and will approach this issue from another angle:

Firstly, the tradition is applicable to a situation where a mosque is constructed over the grave and this matter does not bear any relation to an adjacent place of the buried. In all the buried places, the mosque is placed near the grave of Imams (a’imma) and awliya in such a manner that the mosque is separated from the shrine. In other words, we are having one shrine and one mosque. The shrine is set aside for ziyarah and tawwasul and the mosque near that, for the worship of Allah. Therefore these adjacent places (shrines) are outside the scope and contents of the tradition assuming that the contents of the traditions are the same as what the Wahhabis say.

Basically speaking how can it be said that the construction of mosque over the grave is haram or makruh whereas Masjid al-Nabi (mosque of the Holy Prophet) is placed near his grave?

If the companions of the Holy Prophet (s) are like the stars which should be followed then why, in this case, we should not follow them. They extended the mosque in such a manner that the grave of the Holy Prophet (s) and the shaykhayn have been placed in the middle of the mosque.

If really, construction of mosque near the grave of Holy Imams was unlawful, then why the Muslims expanded the mosque of the Holy Prophet (s) from every angle; while the mosque during the time of the Holy Prophet (s) was placed on the eastern side of the grave, after the expansion, the western side of the grave too became the part of the mosque.

Is it that following theسلف i.e. predecessors and beingسلفي which the Wahhabis are always proud of, means that we should follow them in one instance and disobey them in another?

From this description, it becomes clear that to what extent the sayings of Ibn al-Qayyim that in Islam, grave and mosque do not exist together are baseless and against the path of Muslims. Secondly, we do not derive any meaning from these traditions other than the Holy Prophet (s) prohibiting construction of mosque over or near the graves of the awliya. However, no argument exists to prove that this prohibition is a haram prohibition. Instead, it is possible that this prohibition is a makruh prohibition just as Bukhari has interpreted the traditions and discussed them under the title;

    باب ، يكره من اتخاذ المساجد على القبور

Chapter: It is aversion to build mosques on graves.13

Another testimony is that this matter has come along with the curse upon female visitors to the grave.14 Surely visiting the graves is makruh and not haram for the ladies.

If the Holy Prophet (s) has cursed this group, this curse is no testimony of it being haram because in many of the traditions those committing makruh acts have been cursed too. In tradition, it is mentioned that those who travel alone or eat alone or sleep alone are cursed.

In the end we remind that the construction of mosque over the grave of pious people was an act which was in vogue in the beginning of Islam.

Al-Samhudi says: “When the mother of Ali (‘a), Fatima bint Asad, passed away, the Holy Prophet (s) ordered that she be buried in a place where today stands a mosque named as ‘Grave of Fatima’. He meant that the place of grave of Fatima appear as a mosque in later time. Again he says: “Mus’ab bin ‘Umayr and ‘Abdulla bin Jahsh were buried under the mosque which was built over the grave of Hamza.”15

He further says that in the 2nd century there existed a mosque over the grave of Hamza.16

This mosque existed till the domination of the Wahhabis. They demolished this mosque on these unfounded reasons.

Notes

1. Refer to Tafsir al-Kashshaf of al-Zamakhshari, Ghara’ib al-Qur’an of al-Naysaburi, and others.

2. Sahih al-Bukhari, kitab al-jana’iz, vol. 2, page 111.

3. Sahih al-Bukhari, kitab al-jana’iz, vol. 2, page 111; Sunan al-Nasa’i, kitab al-jana’iz, vol. 2 p. 871

4. Sahih Muslim, vol. 2 p. 68.

5. Sahih Muslim, kitab al-masajid, vol. 2, p. 66.

6. Sunan al-Nasa’i, (ed. Mustafa Halabi), vol. 4, p. 77

7. Ibn Taymiyya, Ziyarat al-qubur, p. 106.

8.إن اولئك إذ كان فيهم الرجل الصالح فمات بنوا على قبره مسجداُ وصورا فيه تلك الصور

9. Ibn Hanbal, al-Musnad, vol. 3, p. 248

10. al-Qastallani, Irshad al-sari; and Ibn Hajar al-‘Asqalani, Fath al-bari, vol. 3, p. 208 approve this view. Prohibition is applicable under circumstances where the grave appears in the manner which was in vogue amongst the Jews and Christians. Otherwise there is no problem and objection.

11. Sunan al-Nasa’i, (al-Azhar edition), vol. 2, p. 21.

12. Sunan al-Nasa’i, (al-Azhar edition), vol. 2, p. 21.

13. Sahih al-Bukhari, vol. 2, p. 111

14. Sunan al-Nasa’i, (Egyptian edition), vol. 3, p. 77.

15. Al-Samhudi, Wafa’ al-wafa’ fi akhbar dar al-Mustafa, (ed. Muhammad Muhyiuddin), vol. 3, p. 897.

16. Al-Samhudi, Wafa’ al-wafa’, (ed. Muhammad Muhyiuddin), vol. 3, p. 922 and 936.