Alhassanain(p) Network for Heritage and Islamic Thought

The Influence of Islamic Philosophy and Ethics on The Development of Medicine During the Islamic Renaissance

Dr. Sharif Kaf Al-Ghazal

MD, MS, FRAS, Cert Plast (RCS), DM

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Table of Contents

Introduction 3

I: Islam and the Promotion of Science 4

II: The Attitude and Contribution of the State 6

III: Islamic Physicians 9

The impact of some Muslim physicians 9

IV: Medical Ethics in Islam 11

Introduction

Although Islamic philosophy is of great diversity and richness, it is characterized by certain features that are of special significance for both an understanding of it and for an appraisal of its impact on the world at large.

One must remember that this philosophy existed at a time in which strict obedience of the Islamic religion was customary.

Islamic philosophy was also concerned with the basic issue of the harmony between human reasoning and the revelations provided to the Muslims in the holy Quran. As a result all sorts of sciences were studied in order to determine that relation between the universe and the human being in one hand and the creature of that universe , Allah (SWT), on the other hand.

The impact of Islamic philosophy on the Renaissance was enormous. First and foremost, Islamic philosophy originates from a time when Islam had a great influence on everyday life. The mere fact that Islamic philosophy was able to operate in such a fundamentalist environment greatly effected the Renaissance for it served as an example the thinkers of that time - how to present new, radical ideas without angering religious fundamentalists, who were the church at that time. Without Islam's example, the Renaissance thinkers may have presented their ideas in a much more provocative form, setting them back hundreds of years due to widespread hate, distrust and non-acceptance of what people would perceive to be overly radical ideas.

Secondly, Islamic philosophy always lead to one main conclusion, that the power of Allah (SWT) was supreme and that his words were the absolute truth.

Thirdly, many of the ideas of Renaissance philosophy are based on ancient Greek, Persian and Indian texts, which the Muslims translated, as well as the philosophy of the Muslims themselves. The Muslims were responsible for creating the foundation for the "building" of philosophy that the Renaissance thinkers would later "construct."

Finally, Islamic philosophy greatly encouraged science, particularly mathematics and medicine. Without philosophy's constant encouraging of scientific development, the large number of discoveries made by the Muslims may never have taken place.

I will take Medicine as an example and I will highlight the reasons of such good success of those Muslims in the field of Medicine and as medical ethics is one of the hottest issues in medicine these days and ethics can be described as a sub-branch of applied philosophy that seeks ‘what are the right and the wrong, the good and the bad set of behaviours in a given circumstance, I will shed the light on the influence of Islamic medical ethics on the advancement of medicine during that Islamic golden era.

So, what are the factors behind the success of the Muslim scientists and how Islamic philosophy encouraged them to be leaders in many branches of science , especially in the medical sciences:

I: Islam and the Promotion of 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 science were 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. These teachings had played extensive roles by:

1. Stressing the importance and respect of learning. For example, the first word revealed to prophet Mohammad (PBUH) was "Read". In that time, a captured enemy was freed if he paid a ransom or taught ten Muslims writing and reading. In the holy Quran, the importance of knowledge has been repeatedly stressed as it says " Say (unto them, O Muhammad): Are those who know equal with those who do not know? "39-9. Prophet Mohammad (PBUH) stressed learning by saying: "One hour of teaching is better than a night of praying."

2. The general philosophy in Islamic medicine is that the healer is Allah (SWT) and the doctor is the instrument that Allah uses to heal the people. The doctor-patient relationship is stronger in Islam than it is in modern medicine as he has responsibilities which he will be asked about them by Allah in the day of judgment.

The relationship now in the west is medical/legal. The emphasis has become one that has slipped into more materialism. Because the relationship between doctor and patient has become one that is based more on money than before, the level of trust has been decimated between the doctor and his/her patients.

3. There is no censorship in Islam on scientific research, be it academic to reveal the signs of God in His creation, or applied aiming at the solution of a particular problem.

Freedom of scientific research shall not cause harm to any human being or even subjecting him to definite or probable harm, with holding his therapeutic needs, defrauding him or exploiting his material need.

Freedom of scientific research shall not entail cruelty to animals, or their torture. Suitable protocols should be laid upon for the uncruel handling of experimental animals during experimentation.

4. Islam provides laws and a basis for the protection and safeguarding of the human body as well as the spirit and seeks to prevent any hindrance to either body or soul. Holy Quran says: "and whoever saves a life it would be as if he saved the life of all the people "5- 32. Perhaps there is no better way to implement this concept than in the area of saving lives by transplanting donated organs to replace failing vital ones.

And the Hadith of the Prophet (PBUH) “Whoever helps a brother in difficulty, God will help him through his difficulties on the Day of Judgement.”

Islam provides rights and protections to all human beings at every stage and area of life. The holy Quran states: ‘Do not kill your children on account of want or poverty, We provide them sustenance for you and for them.’ 6:151

5. Islam developed in Muslims the respect of authority and discipline. For example, realizing the scourges and terror of plague, prophet Mohammad (PBUH) 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. Thus prophet Mohammed (PBUH) laid for the Muslims the laws governing them and made it work.

6. Tolerated other religions. The Islamic religion recognizes Christianity and Judaism and considers their followers to be people with holy books like Muslims. Moreover, they candidly treated the Jews at an era when the latter were persecuted in Europe. Dr. Jacob Minkin, a reputable Rabbi and scholar says "It was Mohammadan Spain, the only land of freedom the Jews knew in nearly a thousand years of their dispersion, while during the Crusades, the armoured 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, but were given the opportunity to live their own lives and develop a culture. So, there were many Christian and Jewish physicians who contributed in the Islamic renaissance (e.g. Jibra'il Ibn Bakhtashoo'e , Youhanna Ibn Masawaih, Ishaq Ibn Honain and Ishaq Ibn Moosa). They were part of that 'Golden Ages' !

II: The Attitude and Contribution of the State

The Islamic empire in the early 8th century were the inheritors of the scientific tradition of late antiquity. They preserved it, elaborated it, and finally, passed it to Europe. At this early date, the Islamic dynasty of the Umayyads showed an interest in science. It was the century that were, for Europeans, the Dark Ages, were, for Muslim scholars, centuries of philosophical and scientific discovery and development. The Arabs at the time not only assimilated the ancient wisdom of Persia, and the classical heritage of Greece, but adapted their own distinctive needs and ways of thinking

One of the early Umayyad princes, Khalid Ibn Yazid (end of the 7th century), gave up his treasure for the study of medicine and chemistry. He studied medicine under John the Grammarian of Alexandria, and chemistry under Merrinos the Greek. He also encouraged several Greek and Coptic medical books to be translated into Arabic.

The Abbasi Caliphs during the 8th century encouraged the Persian physicians to translate into Arabic the medical knowledge therein, to build medical centres 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.

Characteristic Features of Hospitals in the Islamic Civilization

The Muslims played developed what would become the world's first hospitals. The Muslims eventually constructed 34 of these hospitals throughout their empire. These hospitals had different wards for the treatment of different diseases, special quarters for the insane, outpatient departments for the treatment of minor injuries and dispensaries, which provided virtually every kind of remedy then known.

These hospitals had specific characteristics:

a. Secular: Hospitals served all peoples irrespective of color, religion, or background. They were 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.

b. Separate wards and nurses: Patients of different sexes occupied separate wards. Also different diseases especially infectious ones, were allocated different wards. Male nurses were to take care of male patients, and female ones were take of the female patients.

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

d. Baths and water supplies: Praying five times a day is an important pillar of Islam. Sick or healthy, it is an Islamic obligation; of course physical performance depends on one's health, even he can pray while laying in bed. Therefore, these hospitals had to provide the patients and employees with plentiful of clrean water supply and with bathing facilities.

e. Practicing physicians: Only qualified physicians were allowed by law to practice medicine. In 931 A.D., the Caliph Al-Mugtadir from the Abbasid dynasty, ordered the Chief Court-Physician Sinan Ibn-Thabit to screen the 860 physicians-of Baghdad, and only those qualified were granted license to practice.

It is worth mentioning also that the physicians in that 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. before being accepted as a medical student. Therefore, the physician was a educated 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 the Chief-Justice. Many eminent physicians, as we will discuss later, showed enough talent, social knowledge, political capabilities, and wisdom to be appointed by the Caliphs as prime ministers. Owing to the high prestige and connections of physicians, generous funds for hospitals were easily obtained.

f. Medical Regulation: Before the Muslims, medicine had been an unregulated profession, where one could easily fall into the hands of an unqualified doctor. However, the Muslims' introduction of regulation ensured that all doctors were qualified. Prophet Mohammad (PBUH) said ( He who practices medicine and is not therein versed is deemed like a guarantor). The regulations also ensured that doctors did not cheat their patients when it came to drug composition. This concept affected the Renaissance's physicians for it set an example for them, leading them to found various medical associations and guilds for the purpose of regulating their profession too. Hence, one could say that the Muslims' regulation of medicine lead to a safer and more professional medical institution during the Renaissance, which doubtlessly saved countless lives that would have been lost due to medical incompetence.

g. 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.

h. Rulers' involvement in building hospitals: The Caliphs of the Islamic empire built magnificent hospitals for religious reasons, as Islam teaches that money spent on charity is a good investment for Judgment Day ; and for political reasons when they showed their people that they cared, and were interested in them. Whatever the motive of the ruler, the population benefited and good hospitals were established.

i. Adequate financing to run the hospitals: The rulers set aside generous funds to run these hospitals. There was 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 Al-Zakat (2.5% of property value).

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.

III: Islamic Physicians

Medicine in Islam passed through three stages:

1. The first stage is the stage of translation of foreign sources into Arabic. It extended mainly during the seventh and eighth centuries.

2. 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.

3. 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 marvellous job by translating honestly the ancient literature from Greek and old Syrian into Arabic. They translated different branches of science including philosophy astrology, and medicine. The works of Hippocratcs, Aristototle and Galen were among those translated From Arabic, the classic Greek literature was 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. Caliph Al-Mamun Al-Abbassi paid the translator the weight of his translation in gold. Among the eminent physicians who took part in the first stage were Jurjis lbn-Bakhtashoo, his grandson Jibrail, Youhanna Ibn-Masawaih, and Honain Ibn-Ishaq ; most of them were Christians, yet they were respected and well treated by the Moslem rulers.

The impact of some Muslim physicians

-Al Razi (Rhazes) was said to have written more than 200 books, with 100 of these books on medicine. Al Razi's work had a significant impact on the Renaissance. Firstly, Razi's discovery of smallpox was the first differentiation of a specific disease from many eruptive fevers that assailed man. His methods of differentiation were to be utilized by the physicians of the Renaissance when they attempted to do the same with other diseases hundreds of years later. Additionally, his treatise of smallpox was used by Renaissance physicians to treat cases of this disease throughout the Renaissance, saving countless lives. His works on hygiene set an example that Renaissance physicians followed and attempted to improve on. The result was medical procedures that were much more hygienic, again saving countless lives that would have been lost through infection. Finally, his monumental book encyclopaedia (Al Hawi) offered striking insights for its time, and it had a huge impact shaping European medicine during the Renaissance and years after.

-Ibn Sina (Avicenna), honored in the West with the title of “Prince of Physicians”. Ibn Sina's works also had a significant impact on the Renaissance. Firstly, his Canon of Medicine was the most widely studied work of medicine in Europe from the 12th to the 17th century. It also served as a chief guide to medical science to European universities. Needless to say, the impact of this book on Renaissance science was enormous, as it was their primary source of medical information. Ibn Sina's discovery that certain diseases could be spread through water and soil affected the research of many Renaissance physicians. Since they knew how the disease was transmitted, if made their job of finding cures for diseases much easier. It also provided a base for their studies into how disease was spread.

- Ibn Al Nafis who discovered the pulmonary circulation which was re-discovered by modern science after a lapse of three centuries. He was the first to correctly describe the constitution of the lungs and gave a description of the bronchi and the interaction between the human body's vessels for air and blood. Also, he elaborated the function of the coronary arteries as feeding the cardiac muscle.

- Al Zahrawi (Abulcasis) The spanish-born Muslim in the 10th century who wrote about the science of surgery. He was able to perform remarkably complex operations for his time, including cranial and vascular surgery, operations for cancer, delicate abdominal surgery involving the use of drainage tubes, and the amputation of diseased arms and legs.

- Ibn Juljul of Cordoba in 943 became a leading physician at the age of 24, compiled a book of special treaties on drugs found in al-Andalus.

- Ibn-Masawayh wrote the oldest systematic treaties on ophthalmology. The book, titled al-Ashr Maqalat fi al-'Ayn (the ten treaties of the eye) was the earliest existing text book of ophthalmology.

In the curative use of drugs, some amazing advances were made by the Muslims.

They have established the first apothecary shops, and founded the earliest school of pharmacy.

The Muslims were also one of the first people to use anesthetics to render patients unconscious.

IV: Medical Ethics in Islam

-Specific works written by Muslim physicians on the subject of ethics and medicine include the substantive work by

The medical profession was a well respected specialty and its Leaders kept it this way by laying down proper ethics. Ishaq ibn ‘Ali al-Ruhavi (9th century CE) wrote a book entitled Adab al-Tabib or ‘The Ethics of the Physician’.

Al-Tabari, the chief physician in 970 A.D., described also the Islamic code of ethics in his book Fardous Al Hikma (The paradise of wisdom) stressing on good Personal characters of the physician, the physician’s obligations towards his patients, community and colleagues. He stated:

“... The physician should be modest, virtuous and merciful... He should wear clean clothes, be dignified, and have well- groomed hair and beard.... 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 avoid predicting whether a patient will live or die, only Allah knows... He ought not 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 God will reward him if he helps the needy... 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. He should be decent towards women and should not divulge the secrets of his patients...He should speak no evil of reputable men of the community or be critical of any one's religious belief He should speak well of his colleagues.... He should not honor himself by shaming others...”

So, although Bioethics took birth and developed in western world, consequently most of the philosophical bases of bioethics are derived from concepts of western philosophies. In last 25 years the Islamic world has felt the need to introduce courses in Islamic bioethics in order to study the Islamic ethics in the medical field which has been established hundreds of years ago and also to appreciate what sharia'h has to say about the predominant bioethical issues (informed consent, abortion, IVF, euthanasia, and organ transplantation, and many others). It is essential that one is introduced to the tenets of Islamic legal philosophies and theories.

At the end of this article It is worth mentioning that the First International Conference on Islamic Medicine held in Kuwait in January 1981 published the oath of Muslim doctor which says:

I swear by God...The Great.. To regard God in carrying out my profession...

To protect human life in all stages and under all circumstances, doing my utmost to rescue it from death, malady, pain and anxiety.. To keep peoples' dignity, cover their privacies and lock up their secrets... To be, all the way, an instrument of God's mercy, extending my medical care to near and far, virtuous and sinner and friend and enemy... To strive in the pursuit of knowledge and. harnessing it for the benefit but not the harm of Mankind... To revere my teacher, teach my junior, and be brother to members of the Medical Profession.. and to join in piety and charity...To live my Faith in private and in public, avoiding whatever blemishes me in the eyes of God, His apostle and my fellow Faithful... And may God be witness to this Oath.”

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