We eat, sleep, and go to the bathroom. Yet, we never think about how all these physical needs are processed in the systems of our body when they are functioning normally.

Yes, our bodies are created with perfect systems by which our all kinds of needs are met. The digestive system is one of them. Our intestines are key elements of this system, so much so that asking someone “How are your intestines?” would be as comprehensive as asking “How are you?”

Digestive system

Food is critical to life. A human being can bear hunger for one month at most and can only endure a few days of drought. Thus, eating and drinking is crucial.

Foods as we eat them are not convenient for use by the cells. Food must be broken down into smaller pieces. This process begins in the mouth and ends at the anus, and it is called digestion.

The main task of our stomach and intestines is digestion. The teeth, salivary glands, the tongue, and the gullet – as well as swallowing – are essential secondary elements. Additionally, if the pancreas or liver fall ill, it can paralyze the whole system. While also working with the circulatory system, kidneys have the task of reabsorbing useful substances like glucose, amino acids, and water.

Our digestive system works together with the urinary system and the digestive organs like a factory. How these parts work together is still not fully understood, but more detailed research has been performed and revealed more secrets of the digestive system. By means of every discovery, it is realized that this perfect creation has a more intricate structure than is known.

The brain in the intestine

There are more neurons in our intestines than in our spinal cord and the intestines are created in a way that can move independently from the central nervous system. They have their own nervous system, known as enteric nervous system (ENS), which is also called the “second brain. “Within those yards of tubing lies a complex web of microcircuitry driven by more neurotransmitters and neuromodulators than can be found anywhere else in the peripheral nervous system. These allow the ENS to perform many of its tasks in the absence of central nervous system (CNS) control…” [1]. Thus, “… isolated segments of intestine can independently coordinate propulsive movements and propel content without any neural connections to the brain or spinal cord [2].

The intestines take action when food comes into the stomach. This movement is known as colonic migrating motor complexes (CMMC), and it moves the substances that cannot be digested, like bone and fiber. According to neurophysiologist Nick Spencer et al, “The gut wall contains a complete network of intrinsic nerves capable of propelling contents along the bowel, without any requirement of nerves originating in the brain or spinal cord” [3].

Eat different types of food

70% of our immune system cells are in our intestines. A big part of the approximately 38 trillion bacteria in our body are in our intestines, and they are useful; they have a big role in digesting food. Different groups of bacteria feed on different types of food; so for intestinal flora it is very important to have a variety of food on our table. For the ideal day on a plate Dr. Megan Rossi recommends people should “aim for at least 30 different plant species per week.” “The reason for this is that each plant contains different types of fibres and phytochemicals (the super healthy components of plants) that feed different good bacteria. The more plant variety, the more variety of gut bacteria – which is associated with health and happiness” [4].

Pets in our body

For Dr. Megan Rossi, “microbes are like our pets, so you have to take care of them and feed them” [5].

Of course, germ flora in our body is not just limited to the ones in the intestines. Bacteria, viruses, and fungi in our body are nearly scattered throughout the whole body. These living things produce pellicle on our head skin, irritate the gaps between our toes, live on our skin, are on duty among our teeth, and have ecosystems and assigned positions convenient to them. According to the situation, they keep their living spaces healthy or unhealthy. Although they number 50 trillion, they are approximately 200 grams of our body weight.  

Useful microbes

An average size human adult houses about 10¹² bacteria on the skin, 10¹⁰ in the mouth, and 10¹⁴ in the gastrointestinal tract [6].

These microorganisms are useful microbes with duties in our body. The harmless flora of microbes is generally present on the skin, mouth, teeth, nose, throat, and bowel and genital areas. There isn’t normal flora in internal organs except the large bowel. Internal organs have no microbes. If we look closely, flora is inserted in every part of our body which is dirty and has contact with the outer environment. If it was not for the useful flora, microorganisms causing illness would settle instead. Only intestinal bacteria are permanent microbes which are useful. For example, vitamin K plays a part in a crucial event like blood clotting and is produced in the intestine.

Control your stress

Research has revealed that mental and psychological stress affects the health of the intestines. Serotonin is produced automatically in case of need, and 85% of it is produced in the digestive tract. Stress suppresses the level of serotonin produced. Psychological illnesses are associated with low levels of serotonin.

Studies have shown that relaxing practices like meditation for 15-20 minutes can be good for health and reduce stress. At this point, daily prayers are a kind of therapy. Other ways to stay healthy include: avoiding things like alcohol and caffeine, and sleeping well.

Our body has ways of telling us when it’s not healthy. For instance, we can learn the digestive tract isn’t healthy if we have to use the toilet more than three times a day and fewer than three times a week.

References

1. Gershon, Michael D. “The Enteric Nervous System: A Second Brain.” Pdfs.semanticscholar.org.
2. Spencer et al. 2018. “Identification of a Rhythmic Firing Pattern in the Enteric Nervous System That Generates Rhythmic Electrical Activity in Smooth Muscle.” http://www.jneurosci.org/content/38/24/5507
3. http://www.flinders.edu.au/neuroscience/lab_visceral.html
4. https://www.dailymail.co.uk/femail/article-5543159/Doctor-debunks-myths-surrounding-gut-health-say-surprise-you.html
5. https://navva.org/brazil/health/why-the-bowel-is-considered-our-39-2nd-brain-39-and-other-5-amazing-facts-about-the-organ-news/
6. http://www.textbookofbacteriology.net/normalflora_3.html

Digestion in grain-eating birds

The digestive system of the chicken, which is a representative of the world of birds, is comprised of organs lined up in straight line succession: a beak, mouth, gullet, craw, front stomach (with gland), gizzard, small intestine, caecum, large intestine, cloacae and anus. In addition, enzymes secreted from the pancreas, liver and gallbladder also have digestive duties. Ending in a sharp point, the beak was created especially to be able to pick up single pieces of feed. Chickens do not have assisting organs like the palate, cheek, tongue or teeth that are normally found in the mouth, the first door of digestion in most animals. Ruminating animals like cows, sheep, goats and camels use the tongue instead of a beak for taking food into their mouths, and then their teeth are used to begin the breakdown of food. In chickens, however, this breakdown is initiated with the bottom and top beak. In ruminants there are taste buds in different shapes on the tip, sides and middle of their tongues which also function as the organ for the sense of taste. Since such taste buds are not found in chickens, there is also no perception of taste like that experienced in ruminating animals.

The structure and function of the gullet, or food pipe, has similar characteristics in chickens and other animals. However, just as in all birds that eat single seeds and grains, there is another digestive organ in chickens in the shape of a bag opposite to where the gullet expands. Called a craw, this tiny pouch is a place for the storage, wetting and softening of feed, and it serves the purpose of bringing food to the consistency needed for further digestion; consequently, it lightens the burden of the stomach (just like when we leave food that is difficult to cook, like chick peas or beans, standing in water overnight before we cook it).

A chicken’s stomach is composed of two different sections, the front stomach and the gizzard. The feed the chicken eats passes from the gullet and the craw to the front stomach, where digestive secretions are made. The food is stored here briefly and mixed with the special fluids of the stomach. Found in this secretion are both the pepsin enzyme, which starts the digestion of proteins, and hydrochloric acid, which is secreted to generate the pH level that makes this enzyme effective (and which also helps in the dissolution of minerals). These two important secretions are produced by different glands in the stomach. Like the craw, the gizzard, which comes after the front stomach, is the place where mechanical digestion, which is particular to all birds that eat grains, takes place. The gizzard is called the stomach with muscles because it is comprised of a pair of thick and strong muscle layers. As a result of these muscles constricting strongly, feed is broken down mechanically and ground up. While gathering feed, the chicken usually also swallows small pieces of sand, stone and limestone as if it knows how its digestive system works. Although many of us think that chickens swallow stones because they cannot distinguish them from feed, it is obvious that there is a purpose why they are doing it. If these stones, which are like “mill stones” for the digestive tract, are not found in the gizzard, the feed is not fully ground; consequently, it will pass to the small intestine in a form that will not be fully beneficial to the body.

Depending on its characteristics, the feed eaten can stay in the gizzard for a few minutes or several hours. The small intestine, which comes after the stomach, is comprised of the duodenum (twelve-finger intestine), the jejunum and the ileum. The small intestine is similar in grain-eating birds to those of other animals. The duodenum empties the secretions coming from the pancreas and the bile coming from the gall bladder. The digestion and absorption of the feed actually takes place in the small intestine due to these secretions. Final digestion and the absorption of carbohydrates and protein are effected by bacteria found at the point where the small intestine ends, in the 10-15 centimeter-long, V-shaped caecum.

The large intestine and the cloacae are found in the advanced sections of the digestive system. The role of the large intestine, which is twice as large in diameter as the small intestine, is to temporarily store the waste from the digested food and to maintain the balance of water in the body. The cloacae is a small orifice with a structure formed by the widening of the large intestine towards the anus and where the digestive, defecation and reproduction tracts open up.

While giving grain-eating birds the above mechanisms in order to nourish them, God equipped ruminating animals with different oral, dental, gastric and intestinal structures as well as different digestive strategies.

Digestion in ruminating mammals

While secreting saliva is essential for ruminating animals, it is not necessary for chickens because of differences in their digestive system. As a result of the secretion of saliva the fodder of ruminants is softened and dryness of mouth is prevented. Ptyalin (or alpha amylase), which is found in saliva, has antibacterial properties that protect animals from infections in addition to playing a role in digestion. The mother cows constantly licking their newborn calves is both an expression of compassion and also of wisdom in protecting the newborn from probable infections (Similarly, animals like dogs and cats licking their wounds and thus speeding up healing is no coincidence, but a sign of universal wisdom and mercy). This wisdom shows that saliva, of which cows secrete 90-180 liters and sheep 5-8 liters per day, is not a waste.

The stomachs of ruminants are comprised of four sections; the first three are the rumen, the reticulum and the omasum. These three sections are called the front stomach. The section that does the real work is called the abomasum. Because the nutritional value of grass is very low in comparison with meat, it is obvious that a large bodied ruminant will need a lot of grass. Consequently, the capacity of rumen being 150 liters is a wise and fitting design. In addition, the cellulase enzyme that digests the cellulose walls in plant cells is not produced in the tissues of any mammals. The possessor of infinite knowledge and power, God placed high concentrations of bacteria, protozoa, yeast and fungus-all of which can produce the cellulase enzyme needed to break down cellulose-in the rumen of ruminating mammals. The rumen acts as a fermentation factory because of these microorganisms. Breaking down the cellulose-rich food consumed by ruminants, these microorganisms both fulfill their own nutritional needs and help to meet the host’s energy, protein and vitamin (especially B12) needs within a symbiotic relationship. I wonder where the microorganisms in the rumen learned about this synthesis and assistance mechanisms!

What a magnificent engineering wonder is the “sulcus esophagus,” a semi-duct structure in the shape of a canoe that extends from the end of the food pipe in newborn ruminants to the abomasum where the essential stage of digestion takes place. Due to this structure, milk drunk reaches the last stage of the stomach without passing through the rumen, for there is no matter like cellulose in the content of milk that needs to be broken down. Consequently, there is no need for the milk to go to the rumen. If it were not like this, the milk would go directly to the rumen where it would be ruined by microorganisms, lose its nutritional quality and be like a bribe given in vain to the microorganisms in the rumen.

With this act, the holy Pole meant, “Whenever your son’s spirit prevails over his body, and his heart over his carnal soul, and his intellect over his stomach, and he demands pleasure for the sake of thankfulness, then he can eat delicious things.” (Said Nursi, Nineteenth Gleam, 3rd point.)

I too witnessed a similar incident thirty years ago. With a large group of friends from university I was invited to visit a well-known scholar for whom I had a deep respect. We had the opportunity to attend a dinner with him and among the food served were some delicious cherries. My inner voice said, “If I sit near him, I will not be comfortable enough to eat as many of those cherries as I like.” This was exactly what happened. While I was thinking about how to get a chance to eat more of the cherries, that respected person took one of the cherries, excused himself, and left the table. I still cannot forget how ashamed I was of my thoughts at that time.

As a result of the story of Abdul-Qadir Jilani and my own experience, I started to ponder the activities that function so well in the human body. In medicine, the dynamic balance that entirely governs the body during eating, drinking and digestion is known as homeostasis. The most crucial body fluid in this balance is the blood. All the agents in the blood have a fixed quantity, a fixed measure and are supplied at a constant rate. Blood pressure is stabilized according to the characteristics of each vein. For instance, the average blood pressure of large arteries is about 100 mmHg. If the pressure exceeds this figure, then the result is hypertension. Hypertension can lead to cerebral hemorrhages, paralysis, renal failure, cardiac expansion, cardiac failure and heart attacks, all of which can result in death. As for hypotension, this is when the flow of the blood to the organs, mainly the brain, lessens. Another example of the importance of maintaining balance is that the agents which are responsible for maintaining the concentration of sugar in the blood (glycemia) must be kept at a suitable balance. If the ratio of the blood sugar (glycemia) rises, the person may go into a sugar coma, which is life threatening. However, if the ratio of blood sugar drops, the organs, in particular the brain, are deprived of energy. A hypoglycemia coma (when blood sugar is too low) is even more dangerous for the brain than hyperglycemia (when blood sugar is too high). The concentration of sodium, potassium, chlorine, calcium and fatty acids present in the blood, like sugar, are kept in a dynamic balance. If this concentration is upset, the result may be disease or even death. The Owner of Absolute Will and Infinite Mercy keeps all these in balance thanks to the marvelous mechanisms that He has placed in our bodies. However, we are free as far as actions like eating and drinking are concerned, for we are granted the willpower to choose our actions.

Balance in nourishment

One of the most often discussed medical subjects in recent years is obesity. This is an important health problem that poses a threat to life, and it is related to diabetes, hardening of the arteries (arteriosclerosis), fatty liver, cirrhosis, cardiac failure and heart failure. Apart from using one’s own will power and eating less, doctors have presented other harmless ways that are appropriate to human nature to treat obesity. Being overweight constrains the ability of a person to move (exercise) and this inactivity, in turn, leads to more and more weight gain. God has enabled us to seek nourishment wherever we like, within certain parameters. Naturally, our stomach has a certain capacity and when this capacity is met, we feel full and do not need to eat any more. Yet, even though we feel full and should not eat, as this is what is necessary for the health of our body, we are overcome by our lower self and tend to overeat extravagantly. The problem of obesity seems to be greater in developed countries.

Our Creator has not put any restrictions on the absorption of food into the blood. All the food we eat is taken into the intestines so that the nutrients can pass into the bloodstream. If the dynamic balance (homeostasis) were to be maintained here as well then the body would take as much as it needed and the surplus of food would be evacuated from the body without going into the blood; as a result, obesity would not be a concern, however much a person might eat. But by allowing all the food we eat to pass into the bloodstream, the Absolute Ruler has set a test for us, challenging our wills and warning us about self-control.

Most of the activity during digestion and absorption takes place in the small intestine. Our small intestine is a duct which consists of three parts, namely the duodenum, jejunum and ileum, each having different functions and structures. The length of the intestine is 3–4 meters, and it measures 2–4 centimeters in diameter, varying according to the position in the body. The area of the inner surface of this cylindrical structure is 1,600 cm2 (0.16m2) at its maximum. The inner perimeter of the intestine is not like a flat tube, but rather it has folds, each measuring about 8 millimeters, that stretch over the inner parts of the canal. These folds allow the absorption surface to be increased about threefold. If the inner surface of this structure were flat, the absorption capacity of the small intestine would not be more than 1/600 of its present capacity. The surface of these folds is also not flat, but covered with protrusions called villi that are shaped like a finger; these stretch into the vacuum of the canal by about 1 millimeter. There are between 20 and 40 villi to every square centimeter on the surface of the intestine. These villi allow for there to be a tenfold increase in surface absorption. The surface of the villi has cylindrical cells that are arranged in a single row and these help in absorption. The surface of these cells has extensions that are quite thin and dense, known as microvilli, or epithelial cells. Thanks to these cells with a brush border surface, the absorption surface can increase by about twenty times. Thus, although the surface area of a flat canal of the same size should be approximately 3,300 cm2, thanks to surface folds, villi and bushy edges, the total absorption surface of the small intestine increases to 2 million cm2 (200 m2). Moreover, some research has suggested that the total increase could be even greater (about 1,000 times as much). Normally, 100 grams of fat, 50–100 grams of amino acid, 50–100 grams of iodine, and 7–8 liters of water (consisting mostly of fluids produced within the body) are absorbed by the intestines daily. Furthermore, if one eats or drinks too much, the maximum capacity of the system allows the absorption of several kilograms of carbohydrates, a half to one kilogram of fat, a half to one kilogram of protein and twenty liters of water per day. Our intestines have been created with the capacity to transfer all this food into the bloodstream. If we do not control our eating, this capacity is abused and we can face conditions like obesity.

In this life, one of whose tests is in our body, and in which we are required to strive hard using our willpower, there is no limit to the absorption of foods that have high calories (lipid, carbohydrate, and protein), and this can lead to being overweight, as mentioned above. However, in the absorption of minerals, which are not normally considered as making up the basic components of nourishment, but which are of the utmost importance for the human body (in all the operations of the nerves, muscles, bones and in the balance of all the electrolytes), the rules of dynamic balance occur in our intestines, regardless of our will, by the help and mercy of God. For instance, hemoglobin, which is found in the red blood cells (giving the blood its red color) and is charged with the task of transporting oxygen, contains iron. When there is surplus iron in the body, hemosiderosis occurs, which leads to the destruction of organs such as the liver and the pancreas, or cardiac failure. If there is an iron deficiency, then a person suffers from anemia. It is for this reason that a quite sensitive iron-absorption balance exists in our intestines. Here, it is evident without question that there is Divine Aid and Mercy. The same mechanism works for substances like calcium.

Prophet Muhammad’s, peace be upon him, advice to stop eating before feeling full is a significant measure against obesity, for it eliminates “false” appetite. This has a psychological truth, for the brain responds to the feel of fullness a short time after eating. In fact, we all know by experience that we actually feel full a short while (fifteen–twenty minutes) after we stop eating even if it is a small meal.

To conclude, the Almighty One warns us against extravagance and orders us to use our willpower. At this point, we can see how important a role the blessing of religious belief and the training of the soul and the will play in eating habits. Likewise, the principles of Islam, which is in perfect keeping with human nature, are crucial for the well-being of the community as a whole; charitable alms and fasting, which urge us to help and think about those with less, are obligatory and all kinds of charity and good deeds are encouraged. In Islam extravagance is prevented, not only in eating and drinking.

Omer Arifagaoglu is a professor of medicine in Turkey.

Dear Peter, in order for you to understand me better, keep in mind a basic principle about the functioning of living organisms-they all depend on energy use. If no energy enters a living system, then no metabolic activity, no life function can be carried out. Think about a car without fuel. No matter how great the car is, it simply won’t work without any fuel in the tank. The human body is no different. Plants and animal products which people consume as food provide the body with fuel. However, you cannot make use of the energy in nutrients in the form in which you take them in. They need to undergo a process so that they become usable fuel for us, like crude oil being refined into gasoline to make a car work. This is roughly what my duty is. Without my functioning, you would be devoid of the energy to move a finger, and eventually die. Do you understand now how important a set of pipes I am? You just think that I look like a soft and hollow canal and misjudge me as simple. Well, I know that I don’t have such complex parts as the heart, lungs, and kidneys, but I’m created as a perfect work of art in plain design.

Although the hoses you use for watering your garden wear out and break in a relatively short time, my walls made of four layers keep functioning through a lifetime without any holes unless I contract a disease like cancer. My outer layer consists of a durable connective tissue, the next one consists of two sets-one horizontally and one vertically laid-of straight muscles, the next layer under that consists of glands spread in a soft connective tissue, and the innermost layer is the epithelial mucosa where the actual absorption takes place.

Now, let’s come to how I achieve digestion, one of your body’s vital activities. Actually, there is no place for me to take any pride in it; I’m just doing as I am ordered. Anyway, the complex processes occurring within my simple-looking walls are just fascinating! Every one of my cells producing the particular enzymes to break up each nutrient is like a separate factory. Some of these enzymes break proteins into different levels of peptides, some break the peptides into amino acids, some break fats into fat acids and glycerin, whereas some break carbohydrates down into glucose. All of these particular enzymes have their sub-branches within themselves. For example the enzymes breaking down fructose (fruit sugar), lactose (milk sugar), and starch are all different. In order for the enzymes to be effective, my inside needs to have the right pH level; the enzymes work in very sensitive conditions. To give you an idea, the enzymes in the stomach-which happens to be the second station the nutrients are destined for before they come to me-work in an acidic environment (pH: 2.5–3). In my case however, basic fluids are secreted and this strong acidity is neutralized for my enzymes to work.

My overall length is around 8.5 meters from the first entrance at the stomach to the last exit. The small intestine is nearly 7 meters long and the remaining 1.5-meter section is the large intestine. Although the small intestine is the longest section of the digestive tract, it is still called small since it is smaller in diameter than the large intestine.

The small intestine is also divided into three sections. The very short (25–30cm) and relatively thicker part right after the stomach is the duodenum. Bile-which works like detergent and facilitates breaking up fats-produced by the liver and digestive enzymes from the pancreas enter the duodenum. Thus, the nutrients are digested one step further and pass on to the second section (jejunum) and then to the third (ileum). You cannot easily tell apart these final two sections. As blood circulation is more intense in the second section, this section is more reddish and the contractions here are faster and stronger. The third section is narrower and has thinner walls. The blood circulation here is relatively lower and the movements are more limited. The thin membrane of connective tissue (mesentery) around me which attaches me to the abdomen wall and prevents me from knotting up is relatively fatty in this third section.

My most vital parts are the villi-tiny nipples covering the curly surface of my inner wall like a carpet. Shaped like the fingers of a glove, villi yield an enormously large inner surface. They contain a net of capillaries and lymph canals. In addition to the glands secreting the enzymes to break down nutrients, the secretion of certain glands protects me against the destructive effect of the stomach acid. Some cells secrete mucus for lubrication and protection of the passing nutrients. As some cells of the villi secrete digestive enzymes, some of my cells absorb the nutrients broken down until the final phase and pass them to the bloodstream.

Peter, how can some guys mistake such a splendid mechanism as a work of unconscious nature? What I’m telling you about is a manifestation of such great knowledge and might that it leaves you spellbound. I know the characteristics of foods, I know about the other organs’ needs, I adjust various enzymes and an absorption system, I fit them in a limited space… In addition, I do all these in the most ideal way, without any waste or flaw! C’mon Peter, can all these happen by themselves? Now, if I were to start telling everyone about the absorption mechanism in detail, they would probably see those cells as divine beings! The One who assigned special carrier molecules and a system for every nutrient molecule, has placed two transfer systems as blood and lymph pathways in every single one of those millions of villi! The blood pathway passes amino acids, water and salts into the blood directly, whereas the lymphatic pathway absorbs fats to pass them to the blood indirectly. After absorption, the nutrients become a property of the body and they are carried in the bloodstream to all the cells waiting for them in need.

Well, what about the waste then? Since everything you eat is not beneficial and usable, and some things are even toxic, they should be disposed of as soon as possible. The unabsorbed remnants are still too watery to be disposed of; sending them away as they are will be a waste of water and minerals. But don’t worry, everything is perfectly planned! Now the large intestine comes on duty. In this 1.5-meter section, the water of the waste and certain minerals are absorbed, and the waste solidifies. The large intestine is also divided into three sub-sections. The pouch connected to the junction of the small and large intestines is named the cecum and there’s the appendix at its end. This end sometimes festers and you have to have it removed in an appendectomy. Now, there’s this made-up story that the appendix was once longer since your ancestors only ate plants, that it has evolved into a shorter form for I now eat more meat, so on and so forth… Bah! Nothing is created in vain, Peter. If it didn’t have a duty, it simply wouldn’t be created. Only after some time did it dawn on them, after researchers proved that it is so necessary, that as a lymphoid organ, rich in blood vessels, it produces antibodies to fight the germs which somehow make their way into me.

The rest of the large intestine is the colon and the rectum. The mucosa covering my inner surface is rather smooth. It secretes mucus to facilitate the removal of waste. In addition, useful bacteria are made to work in abundance in the large intestine for your needs. These bacteria synthesize the group B vitamins like B12, thiamin, and riboflavin, along with vitamin K. You see how all the processes are carried out so splendidly? If it weren’t for vitamin K, your blood would fail to coagulate, and the slightest injury to your blood vessels would kill you. Could you ever have imagined that what looks to you like a sewage canal could produce vitamins of vital significance? Your Creator has infinite wisdom.

Peter, now you may wonder how the acts of this organ which resembles a long hose are regulated, how the nutrients inside are propelled, and then thrown out. To put it briefly, the “willful” part of your brain does not even know about it. Indeed, if it knew, it would be constantly busy with me and unable to do anything else.

Under the control of the autonomous nervous system, the straight muscles of my walls gradually contract in waves-this is squeezing act is called peristalsis. The nerve fibers connected to me fall into two basic categories-sympathetic and parasympathetic. As the sympathetic fibers pressure me to slow down, parasympathetic fibers stimulate me to act. Thus, I try to keep a balanced functioning between these two opposite effects. When the waste material I propel this way assumes a state to be disposed of, it reaches the rectum, and when the walls here strain, I make a natural call to you that I need to get rid of garbage. This is the step where your will has a partial interference.

Colon cancer, which troubles many people today, appears in this final section. The major reason is consuming too much meat and fatty foods, lack of movement, and leading a stressful life. When these are combined, I fail to function properly. If you want to help me at that, you should consume fiber-rich foods such as fruit and vegetables, and also lead a peaceful life. My web of nerves is amazingly rich and complex. Therefore, I am sensitive to nervous changes. If you feel down or sad, and if you suffer too much stress, I begin to go into spasms. Then I fail to dispose of waste, the toxic material inside me begins to damage my inner walls and eventually increases your cancer risk. Therefore, you’d better take up the habit of a glass of warm water when you get up in the morning, and try to have regular meals at the same times of the day. Most importantly, always have fresh green vegetables on your table, reduce meat intake… and it would be great if you could afford to consume olive oil rather than any other.

Hey, wait! I was about to forget the most important point. If you don’t have any peace of mind, all of these will be useless. This doesn’t mean that you will never worry; after all, this world is a testing ground and you are a human being like anyone else. However, if you give in to troubles and get overcome by feelings like panic, fatigue, and hopelessness, then my functioning will be upset. So, troubles faced with active patience and effort without giving up hope do not harm me much.

Peter, I do not wish you to wait until you see colon cancer patients disposing of waste through a hole in their belly into a plastic bag before you feel grateful for the blessings you enjoy. Actually, maybe I have told you at most a tenth of what I know about myself. Anyway, I think even this much will give you an idea of what a work of art I am. Thanks for listening to me, Peter!

Irfan Yilmaz is a professor of biology at Dokuz Eylül University, Izmir, Turkey.

I am not a tailor, I do not make or sell clothes for a living, I am not in the textile business in any way. Even so, what had brought me to this exhibition was curiosity about such devices as stitches, stitching needles, scissors and the like. More precisely, I had come to see what I could find out about the history and development of such devices in relation to cutting and joining in surgical procedures, especially sutures. 

Every display in the great hall was presented by a team of experts who were there to answer questions. I asked many. In the end, rather to my surprise, I met one expert who was able to give me the kind of help I was looking for. He was Paul Breuer from Aachen, representing the German company SNF MANF, who, as it happens, manufacture surgical needles. Paul Breuer astonished me with his knowledge of a wide range of methods for sewing skin, including the use of ants. Naturally, I was intrigued, and Paul promised to post to me a photograph of an ant being used as a skin stitch, after his return to Aachen.

An embroidery equipment specialist, Caroline Sayers, of the company DATA STITCH, said she could design an ant stitch, if I could supply her with a suitable photograph. The very next day after I had supplied the photograph, the ant was scanned, digitized and an embroidery machine executed for us the amazing ant stitch.

My curiosity about this unusual suture technique led me to further investigations which finally bore fruit when I came across Welcome Institute for the History of Medicine’s 1973 publication, Albucasis on surgery and instruments. This book is a definitive edition of the original Arabic text with English translation and commentary by MS. Spink and G.L. Lewis.

In Book 2, Chapter 85, on suture materials used by the Arab surgeons, Albucasis (the Latinized version of Abu l-Qasim) mentions two techniques. Spink and Lewis, 1973, p.538, comment:

1. Ants’ nippers. This is not a classical method; but is said to be used by African tribes as a way of bringing skin edges together (modern Michel clips); evidently the Arabian ant-nippers acted in the same way.

2. Gut sutures. Gut was used by the earliest Greeks for bow-strings; but it is not mentioned as used for surgical purposes until the Arab era of surgery. Albucasis then describes it as ‘rubbed-down gut, well cleansed’. This may be the earliest reference to this now universal suture material.

Abu l-Qasim’s own account (ibid., p.550) is a vivid description of sutures using ants and cat gut:

Some men of experience have said that when a wound occurs in the intestine and it is small, it should be sutured in this manner, namely: ants with large heads are taken; then the edges of the wound are brought together and one of these ants is applied by its jaws then the head is cut off, and it will stick and will not loosen. Then another ant is applied near the first; and you proceed after this manner with a number of ants according to the size of the wound. Then reduce the intestine and sew up the wound; for the heads will remain sticking to the intestine until it is healed up; and no harm will come to the patient.

The intestine may be sewn up with fine suture which is extracted from an animals gut and sticks to it after being threaded in a needle. The method is that the end is taken of this suture made of gut, well scraped; and to this end is fixed a linen thread, twisted, and then that thread is passed through the needle affixed to the suture of animalis gut, with which the intestine is sewn and then replaced in the abdominal cavity (Abu l-Qasim al-Zahrawi, Al-Tasrif, Book 2 Chapter 85).

Abu l-Qasim Al-Zahrawi (936-1013) wrote his remarkable surgery manual Al-Tasrif during the period of Arab/Islamic rule in Spain about a thousand years ago. I felt a curious and wonderful sensation at the link between an ant stitch, mentioned and talked about in an exhibition of textile craftsmanship in Manchester near the end of the twentieth century, and the dedication and craftsmanly skills of the Muslim scholar who, a millenium before, had adapted the use of ants, and invented the use of cat gut, for making sutures. This was not the only contribution this extraordinary man made to the development of modern surgery techniques, nor was he the only Muslim to have made significant and striking advances in the field of medicine.

It is hard not to feel awe (and, naturally, some pride) at the achievement of the Muslims in that great period of Islamic civilization. I have no doubt that their success was owed to the excellence of their faith and their consequent commitment to working for the improvement of human well-being and the advancement of learning. And I realize that I am merely at the beginning of a long quest for information about what was achieved by Muslims dedicated to Islam in the broadest sense-namely, a way that improves the quality of human life and the quality of our understanding of the world we live in.

Modern medical practice has come back to the conclusion that diet is the key to good health and investment in good dietary advice will lead to a reduction in treatment costs, Emphasis on diet is a principle universal to almost all forms of traditional medicine. You can find sound advice on diet everywhere from Europe to China. The Prophet of Islam, upon whom he peace, set out the dietary principles that led to great advances in Arab and Islamic medicine. He said:

The stomach is the well of the body and the veins drink from it. If it is healthy, the veins pass on good health, if it is sick the veins pass on poison.

The term himya is used to mean both diet and precaution. Harith, ‘the doctor of the Arabs’, said: himya is the source of every cure and the stomach is the home of every illness’. To understand what is meant by himya we should recall the incident when the Prophet and his cousin, Ali, were invited to eat at the house of Umm al Mandari. Muhammad, upon whom be peace, began to eat and then stopped and said to Ali: ‘You are recovering.’ He gave him some barley and chard saying, ‘This is better for you’.

Himya has three functions: 1) it is used as a cute; 2) it is used to maintain good health; 3) it is used alongside cures to aid recovery

Diet and balance

In our previous article, we described the concept of mizaj, balance. Cures are prescribed according to the type of imbalance. Certain foods are classified as ‘moist’, others as ‘dry’. They match their opposites. The simplest example can he found in the Prophet’s advice: ‘Fever is from the fire, put it out with water.’ Another example would he rubbing olive oil on dry skin. One may say that these ideas are common sense and not really medical principles.. However, developing from these ‘simple’ examples came the system of medicine which went on to set the foundations for modern medical practice. Al-tibb al-Nabawi influenced surgeons and physicians like Ibn Sina and al-Hazen. It appears that in the rapid advancement of science many forgot these basic simple ‘common sense’ truths. Now we find ourselves again returning to the idea of a balanced diet.

Diet is normally described in terms of the three macronutrients, namely proteins, fats and carbohydrates. The structural parts of all body cells are made of proteins. It is these which stop them from collapsing. They are also vital in the functioning of the cells. Every protein consists of a string of building blocks called amino acids. The human body needs about 22 amino acids to make its necessary proteins. Fourteen of these can be manufactured by the body. The remainder have to be obtained through our food.The US National Academy of Sciences recommends 0.8 gms of protein per kilogram of body weight. The concept of balance is very important. It has until recently been commonly accepted that red meat is an ideal source of high-quality protein. A recent British report has been interpreted as suggesting that a vegetarian diet actually optimizes health. The reason for this is that taking in large amounts of ‘first grade’ protein from meat inevitably leads to an increased intake of harmful animal fat. This was clearly understood by the Companions of the Prophet. He told them; ‘The lord of all foods for the people of this world and the next is meat’ (related by Ibn Majah). ‘Umar also warned them: ‘Be careful of meat for it has harm like the harm found in wine.’ Another Companion of the Prophet said: ‘Do not make your insides a graveyard for animals.’ Balance is vital. ‘Second grade’ proteins found in grains and legumes are just as effective when combined with ‘first grade’ meat proteins. The different types of meat and their contribution to mizaj, can he found in Ibn al Qayum’s al – Tibb al-Nabawi. It corresponds to the now widely accepted view that red meat is vital but must be balanced with fowl and vegetables.

The second of the macronutrients are fats. They are composed of fatty acids, long molecules of carbon, hydrogen and oxygen. They produce more than twice the amount of energy of proteins or carbohydrates and also carry vitamins A, D, E and K. They are vital for growth and repair, as well as for insulating the body and maintaining a regular temperature. They cushion vital organs. There are several kinds of fat. They differ according to their degree of saturation. Saturated fats produce high levels of blood cholesterol. Cholesterol is a complex waxy substance that is essential to the walls of body cells, the production of vitamin D, hormones, bile acids and nerve tissues. The liver produces cholesterol naturally and does not need any from the diet. Therefore, any added will be excess and lead to imbalance. High cholesterol levels have been associated with high risk of heart attack. A simple way to reduce cholesterol levels would be to moderate the use of eggs and organ meats such as liver.

Carbohydrates are the third of the macronutrients. They provide the body with energy help control the breakdown of protein, and protect the body against toxins. Carbohydrates are of two types. Monosaccharides are simple single molecule sugars. An example is glucose. Polysaccharides are more complex molecules and are broken down into two or more sugars.An example is starch. They arc found in fruits, vegetables and grains. They have a high nutritive value and provide vitamins, minerals, proteins and fibre. Polysaccharides take longer to digest and are therefore more effective in keeping away hunger. Barley has been a vital ingredient in Arab medicine dating back to the Messenger as well as an important part of his own and his followers’ diet.

Digestion

A pillar in al-Tibia al-Nabawi is that illness can be related to diet and digestion. The Messenger laid special importance on position while eating as well as going to toilet. He emphasized the importance of oral hygiene and exercise. The ‘stomach’ mentioned in the saying of the Prophet quoted earlier is generally understood to refer to the whole digestive system. We are being told to keep our whole body in order. Looking carefully after our diet and digestion means looking after our whole body and ultimately our minds and inner selves. Optimum digestion means optimum health.

Digestion begins with the mouth and the teeth. Food is broken down by chewing and is moistened with saliva which stimulates the rest of the digestive process.It is then swallowed as holus. This should take a few minutes. Problems associated with this process include the interaction of bacteria and sugar or other carbohydrates. This breaks down the protective enamel and causes tooth decay. We are told to use siwak, a simple tooth stick, when we make ritual ablution. It is said to he purifying for the mouth, pleasing to the Lord and it makes the devil angry. In al-Tibia al-Nabawi, oral hygiene is not only for good health, it is a part of worship. The Messenger, upon whom he peace said, ‘Prayer with siwak is better than 70 prayers without it.’

The bolus passes to tile stomach via the muscular oesophagus. Reflux of stomach acid during this process leads to heartburn. This, according to al-Tibb al-Nabawi, can he avoided by sitting in a relaxed position while eating. The Messenger said: ‘I do not eat while leaning,’ and ‘I sit as a slave sits and I eat as a slave eats’. He used to sit and eat on the floor with his thigh resting on his foot, with due respect to his Lord and also to those he was eating with,

After the bolus has passed from tile oesophagus it enters the gallbladder. The gallbladder stores bile made by the liver and releases it into the duodenum. Gallstones are the main prob1em associated with the gallbladder. This can he avoided by himya, correct balanced diet. A diet low in animal fats reduces the risk of gallstones.

The bolus passes into the stomach which is a muscular sac that mixes acid fluid with food which then passes into the intestines. The stomach was described by the Messenger as ‘the well of the body’. It is very important that the well is kept clean. Dieticians are now beginning to fully realize the damage that is done to the stomach through smoking, alcohol and irritant foods. Fasting to ‘give the stomach a rest’ is now a common treatment. The role of fasting in Islam is well known. The obligation to fast-for one month a year benefits the Muslim’s body, mind and soul. The commended regular fasting throughout the year is either three days in the middle of the month, or on Mondays and Thursdays.

There are two intestines in the digestive system. The first, called the duodenum or small intestine, is a tube that receives strong alkaline juices from the pancreas and gallbladder which break down fats and neutralize stomach acid . The most common illness related to the small intestine is duodenal ulcers. These are commonly caused by alcohol, smoking and stress.

The passage of food takes four hours in the stomach, about four and a half in the small intestine and finally about twelve hours in the large intestine. The large intestine is a tube in which food and fluid are absorbed. Food residue is formed into faeces.

The final stage of digestion, i.e. the removal of waste, is just as important as the first. The Prophet recommended we sit or squat to avoid constipation. He was very particular about keeping the private areas clean and therefore free of infection, the use of water and performing ablution afterwards. This is not detached from worship. The prayer that he, upon him he peace, said when he completed this final act of digestion sums up the approach of al-Tibb al-Nabawi. Al-Tibb is looking after one’s health, physical and spiritual and, at the same time, remembering the source of all food and all health. He used to say:

All praise belongs to God who took out from me that which harms me and left in me that which benefits me’.