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’.

I once asked an Austrian friend of mine who had just qualified as a doctor where he went when he was sick. The surprising answer was that he and most of his colleagues went to a homeopath. He reminded me of our family G. P. who didn’t believe in medicines. I was told ‘just take your son home and make sure he eats well’.

My friend’s preferring a homeopath to one of his fellow professionals, was as I later found out, a rejection of what he had learned during his many years of study. He felt that he had been taught a set of beliefs, which, in his words, ‘did more harm than good’. He believed that he had been trained to ‘manage symptoms using chemicals’ and that his profession had nothing to do with looking for cures or curing people. He told me that he felt dirty when he had finished his shift and that he wasn’t being ‘true to himself’.

My friend may be an exception and is probably frowned upon and dismissed as a crank by other doctors, but, his views raise many interesting issues relevant to professionals and non-professionals alike.

There is an increasing interest in alternative approaches to health. The rise in health shops and alternative clinics show that the world of commerce is cashing in on this fact. Most bookshops stock books on acupuncture, homeopathy and other forms of Eastern medicines. However, the West’s search for an alternative has overlooked the medicine of the Muslim world, sometimes referred to as al Tibb al Nabawi, the medicine of the Prophet or Islamic medicine.

At Tibb al Nabawi

The name al Tibb at Nabawi literally means prophetic medicine. It is based upon the sayings of Muhammad, upon him be peace. However, it encompasses much more than the relatively small number of prophetic sayings. It incorporated Greek and Indian philosophy and practice wherever they were found to be in accordance with the general principles of Islam. The sayings of the Prophet set down general guidelines and principles which later led to the great discoveries and observations of the likes of Ibn Sina and other Muslim thinkers.

This series of articles will be an introduction to some of these principles.

Illness

The word illness, mard, is used in the Qur’an in two different ways. ‘It is no fault in the blind nor in one born lame, nor in one afflicted with illness (mard)’ (Al-Nur, 24.61). This example and the verses like it give special licenses to one who is sick. These licenses include delaying the compulsory fast and not having to fight during wartime. Verses such as ‘and any of you who is ill or has an ailment in his scalp should in compensation either fast or feed the poor’ (Al-Baqara, 2.196) which refer to the sick pilgrim not having to shave or cut his or her hair, led Muslim scholars to attempt to find a legal definition of the word mard illness.

The jurists set out the basis for practical diagnosis. They identified the means by which one could judge illness which included irregularities in the blood, urine, stool, and semen; imbalance in patterns of sleep, eating and drinking and the appearance of wind, sneezing and vomit.

Illness was defined as being ‘out of balance’. This encompassed both physical and mental states. The mental or emotional state is the second usage of the word mard in the Qur’an. ‘In their hearts is a disease (maid)’ (Al-Baqara, 2.15) The heart (qalb), here, refers to ‘the seat of the emotions’, Physically, one is considered to have an illness if one is ‘out of balance’. Likewise, one is emotionally sick if one is out of the natural and pure state that we were created in.

Doctors are needed for some of these emotional and physical illnesses; for others they are not. Tiredness is a symptom of being ‘out of balance’ which can be rectified simply by sleeping.

Islam sees the ultimate curer of these states to be the One who created them. He sent doctors to His creation such as Jesus who cured the leper as well as those suffering from pride and inflated egos. The last of these great doctors was Muhammad, upon him be peace, who, through his advice and practice, set out principles for curing both types of illness.

The state of balance

Common to many systems of alternative medicines is the concept of ‘balance/imbalance’. One’s natural healthy state is a balance between the four qualities of dryness/wetness and hot/cold. The reason a person may have left this state can be either ‘material’ or ‘consequential’. Material sickness is where a substance has entered the body and has caused its balance to shift in one of the several directions. Once the substance is gone the body will return to its natural mizaj, the model of balance.

A ‘consequential’ illness is where the effect of a substance in the body remains after it has left the body. The body is left with an excess of heat/cold or dryness/moisture.

Prophetic medicines sees illness as being caused by either this state of imbalance or damage to an organ or to the natural weakening caused by old age. The doctor’s first job is to discover the cause of illness, consider its cause, think what might encourage it to return it to its correct state act upon that and then depend on the Creator.

SOME BASIC PRINCIPLES

Preparation of medicines

Most medicines in al Tibb al Nabawi are based on the dietary advice of the Messenger, upon him be peace. A simple illness requires a simple medicine. The cure for imbalance leaning towards heat would be something cold. The classic example is the fever. The Prophet said ‘fever is from the hell, put it out with water.’ (Bukhari and Muslim)

A complex illness e.g. one leaning to hot-dry would require a complex mixture, in our example a cold-dry cure.

Every illness has a cure

The Prophet, upon him be peace, said ‘for every illness there is cure. If the cure matches the illness, improvement will take place by the permission of God.’ (related by Jabir in Muslim) and ‘God did not send down an illness except that He sent down a cure (Bukhari).

The above sayings establish there important principles. Firstly, they encourage the administration of medicines. There is agreement among the majority of Muslim scholars that it is a must. Secondly, they imply that, if administering medicine is a compulsion, then searching for a cure must also be a compulsion. Finally, they emphasise the dependence on God. In this modern age of ours we tend to depend on the medicines and not on the True Curer. It is interesting to look at how few remember God in illness until they realise their illness is terminal and that there is no hope for a cure. My own experience is that it is extremely upsetting and often devastating for both patient and doctor when the limitations of modern medicine dawns on them.

Cure may include spiritual as well as physical medicine

Muhammad, upon him be peace, described specific cures which included the likes of honey for the chest and liver. He also described procedures and principles, e.g. ‘emptying the stomach and putting out the fever with water’. In addition, he prescribed prayers and supplications for things like headaches and general sickness. These can be found in the books of hadith, traditions, as well as in the various books of prayers of the Prophet.’

Diet is the key to good health

Himya meaning both precaution and diet. Himya, with both of these meanings is the central pillar of Islamic medicine. The principle is found in the Qur’an which permits the use of sand in place of water in ablution and washing, if the latter is found to be detrimental to health. There was an occasion when the Prophet came with his cousin, Ali, to the house of Um al Mandari bint Qays al Ansari. They began to eat when Muhammad, upon him be peace, stopped and said to Ali ‘you are recovering.’ He took some barley and chard and gave it to him saying ‘this is better for you (related by Ibn Majah)’ The incident is an explanation of the principle of himya in its fullest sense.

Harith, described as the doctor of the Arabs, said ‘himya is the source of every cure, the stomach is the home of every illness.’ The Messenger 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’.

Dietary precaution himya, can be used in three stages.

1. As a cure

2. To keep the body healthy.

3. To aid recovery

Based on the model of Ibn al Qayyim, hakims and traditional doctors have developed a sophisticated system of dietary medicine.

General behaviour and basic hygiene

The Messenger came to perfect behaviour. He taught not only us what foods we should eat hut how they should be prepared. Things like covering food, washing hands before eating and boiling food thoroughly when cooking were all stressed by the Prophet. The same is true of the etiquette of eating. The Messenger taught us to sit in such a manner that our stomach can be filled only to a third of its capacity.

Dieatry advice

The Messenger, upon him he peace, mentioned over seventy specific foods which he considered healthy. Modern science has confirmed that he was right. Among the foods mentioned were honey, dates, vinegar, fish and ginger.

*This article was based on Al Tibb Al Nabawi which is the final section of the book Zad al Ma’d of Ibn al Qayyim al Jawzi. It will be followed by a series of articles expanding on some of the points mentioned above.

References 

1. AL BUKARI (1980) Jami al Sahih
2. AL HAKIM (1965) Majmu’ Zawaid
3. IBN AL QAYYIM (1987) Al Tibb al Nabawi al Taiba
4. MUSLIM (1965) Jami al Sahih