Washing our hands has become one major way to protect ourselves from Covid-19. However, ablutions have always had a central place in the practices and beliefs of many religious traditions. Christians perform baptism with water, in amounts varying from small sprinkles to larger vessels, to bring about purification, cleanliness, revival, and rebirth. Jesus’ washing the feet of his disciples as narrated in the Gospel makes the washing of feet an important practice in Christianity to promote cleanliness and is still carried out to this day. The Jewish tradition also has many instances of ablution where water is specifically used to promote cleanliness, including washing hands to reclaim or preserve purity and mikveh in which the feet or whole body is immersed in water.

The Islamic ablution, also known as “wudhu,” contains 24 washing movements to be carried out several times a day for the five daily prayers. If performed for all five prayers, it would consist of about 120 repeated actions as Muslims washed parts of their body.

A lover must undertake the required preparation to cleanse and beautify oneself before meeting with their Beloved. Likewise, a believer is required to wash specified parts of their body to stand before God in supplication, as instructed in Chapter Maidah of the Qur’an, verse 6: “O believers, when you stand for prayer, wash your faces, and your hands up to the elbows, and wipe your heads, and wash your feet up to the ankles. If you are unclean, bathe and purify your bodies fully. But if you are ill or in the middle of travelling or … you cannot find water, then take wholesome dust and wipe your faces and hands with that. For God does not wish to burden you, rather He desires to purify you and to complete His blessing and favor upon you so that, perhaps, you may be grateful” [5:6].

The spiritual cleansing that the act of wudhu provides is highlighted by the Prophet Muhammad (pbuh) in numerous hadiths, or prophetic sayings, which has been collected under The Book of Purification. While water literally cleans the face and limbs, with every pure intention to do wudhu, the water droplets that meet the body also wash away the minor sins that were committed by the hands, mouth, face, ears, and feet. The famous hadith that “cleanliness is half of faith” [Sahih Muslim, 223] can be interpreted as applying primarily to doing wudhu in one translation [Wudhu: Fiqh, Rules, Purification and Blessings, Qadri]. Therefore, to perfect the faith, to be cleansed of our mistakes continuously, God has given us a simple mechanism through which to be purified and recalibrated countless times in a day.

Many of us perform this pattern of washing with little thought. It has become a routine that we seldom consider a medical protection that we apply to our body. Besides its effects on the soul, washing also has wonderful effects on the body. Over fourteen hundred years ago, the Prophet (pbuh) advised ablution before going to bed. Interestingly, yoga experts in recent years have also started to encourage the washing of the legs, hands, arms, eyes, and the mouth before sleep with cool water for a deeper undisturbed sleep. This is not surprising considering the relief that comes with the touch of water on a busy day.

Three of our principal systems benefit from wudhu; the circulatory system, the immune system, and the electrostatic balance of the body. In this way, the health benefits from the ritual of washing are threefold…

Circulatory system

The circulatory system is a magnificent circuit of blood vessels between the heart and the tissues that make up every other system of the body. The systemic circulatory system circulates oxygenated blood from the heart to the tissues around the body and back to the heart, whilst the pulmonary circulatory system transports deoxygenated blood to the lungs for detoxification and returns clean blood to the heart. The correct functioning of the blood vessels, which act as wires that connect our major organs, are essential to the efficiency of this circuit. These vessels divide into thinner branches called arterioles which in turn split into smaller capillaries which surround the cells of the body. The vascular resistance generated by blood vessels is overcome by the blood pressure generated by the heart to enable blood flow. Over time (due to ageing, or a diet high in fat), our blood vessels often harden and become constricted meaning that the heart has to work harder to overcome increased vascular resistance to maintain steady blood flow. The vessels in the limbs are the most peripheral to the heart and thus the most vulnerable to the process of hardening and narrowing over a long period.

The application of water in our daily routine “exercises” these blood vessels by alternately contracting and dilating them. Water can act as an agent of temperature gradients, thereby affecting the thermoregulatory response of the cutaneous circulation. When hot, water ensures that vessels in the limbs dilate, and when cold, that they contract. In this way, water ensures the flexibility of vessels distant from the heart, forcing nutrients deposited in tissues as a result of poor circulation back into the bloodstream through a temperature gradient.

Lymphatic system

The lymphatic system, on the other hand, is probably not the first to come to mind when we think of the body’s organ systems. Yet without this quietly working system our cardiovascular system would collapse and our immune system would be impaired. Our lymphatic vessels transport “leaked” blood fluids into our capillaries to prevent the accumulation of fluid in the interstitial spaces and eventual tissue damage. The vessels of the lymphatic system are much thinner than those of the cardiovascular system, ensuring the circulation of white blood cells which have an essential role in protecting the body against invaders and resisting disease. It is this fluid that we see oozing out when we have a cut or wound.

The optimal functioning of this system and its thin vessels, like those of the circulatory system, can be said to be closely linked with the effect of washing. The phagocytes and lymphocytes, which make up the immune system are housed by our lymphoid tissues and organs, are supported by the act of wudhu. The nasopharyngeal region behind the nose leads to the tonsils, which are small masses of lymphoid tissue that trap and remove pathogens that are entering the throat. Washing the mouth and nose three times with every wudhu therefore helps to remove the bacteria that builds up in the region of the body most exposed to the external environment. Moreover, the act of washing both sides of the neck during wudhu stimulates our cervical lymph nodes – a specialized mass of tissue which houses lymphocytes and particularly helps to protect the body by removing bacteria and tumor cells from lymphatic circulation. Our lymphocytes are arguably the most important component of our immune system, patrolling every point of the body many times a day and destroying cancer cells and pathogens along the way. Considering that the act of wudhu enhances the filtration effect of our lymphoid circulation, one can see the blessings that come with the divine command to “wash…and purify your bodies fully….”

Electrostatic balance

Our physiology is also closely related to the electrostatic balance of the body. While many psychosomatic diseases result from electrostatic imbalance, the most pronounced effect of static electricity is exerted on the subcutaneous muscles located under the skin, mitigating their function and inducing the onset of wrinkles which often start in the face. Maintaining the regular habit of washing the skin – particularly the face which is most frequently exposed to ultraviolet radiation – protects the surface and internal layer of our skin cells by constantly dampening the skin surface with clean water. It is a much simpler alternative to spending hundreds and hundreds of dollars on expensive skin care and makeup products to maintain a healthy complexion.

In regards to how wudhu can benefit our electrostatic balance, the part of the verse which sheds light to tayammum, “if you cannot find water, then take wholesome dust and wipe your faces and hands with that” highlights that the water substitute for wudhu significantly reduces static electricity, like water. This is why when wudhu is performed calmly with care, it often leaves one feeling refreshed and discharged.

The Quran is a grand source containing many prescriptions for good health. While every civilized person may wash their face and hands throughout the day, wudhu ensures that cleanliness and a sense of well-being is sustained by virtue of its association with worship. The worth and significance of wudhu is not limited to the medical benefits discussed here. However, for anyone else wondering why taking a pause on a busy day with wudhu feels so rejuvenating, I hope this humble article sheds some light to a grand prescription from among the many medicines revealed in the Qur’an.

{module Science Square (Issue 128)}

First miniature human heart printed

Noor N et al. 3D Printing of Personalized Thick and Perfusable Cardiac Patches and Hearts.  Advanced Science, April 2019.

In a major breakthrough, researchers have “printed” the world’s first 3D vascularized engineered heart using a patient’s own cells and biological materials. This could have huge repercussions for human health: the World Health Organization said that last year, ischemic heart disease and stroke were the world’s leading cause of death for both men and women. Heart transplantation is currently the only treatment available to patients with end-stage heart failure. Given the serious shortage of heart donors, scientists have been trying to develop new “3D organ printing” approaches to regenerate the diseased heart. Past studies were only able to print simple tissues without blood vessels. The new study showed for the first time that an entire heart with cells, blood vessels, ventricles, and chambers could be successfully engineered and printed. The researchers first took a biopsy of fatty tissue from patients and separated the cellular and a-cellular materials of the tissue. While the cells were reprogrammed to become pluripotent stem cells, the extracellular matrix – a 3D network of extracellular macromolecules such as collagen and glycoproteins – were processed into a personalized hydrogel that served as the printing “ink.” After being mixed with the hydrogel, the cells were then robustly differentiated to cardiac or endothelial cells to create patient-specific, immune-compatible cardiac patches with blood vessels and, subsequently, an entire heart. The heart was 3D-printed in about three hours and was too small for humans. It was the size of a rabbit’s heart (~ 2.5 centimeters). But it is completely biocompatible and, most importantly, matches the patient, which reduces the chances of organ rejection inside the body. A human-sized heart might take a whole day to print and would require billions of cells, compared to the millions used to print these mini-hearts. While it’s not clear if a printer can produce hearts that are equal or superior to human ones, perhaps by printing patches there will be a possibility to improve or take out diseased areas in the heart and replace them with something that works. Researchers hope that maybe in 10 years, there will be organ printers in the finest hospitals around the world, and these procedures will be conducted routinely.

Bacterial factories for spider silk

Zhang F et al. Synthetic Biology for Microbial Production of Protein-based Materials, the American Chemical Society (ACS) National Meeting & Exposition, Spring 2019.

Spider silk has always fascinated researchers due to its lightweight and superior strength and numerous applications in areas such as drug delivery, smart textiles, and artificial muscles. It is one of the strongest natural materials in the world. It is thinner than a human hair, but its strength is more than that of steel, pound for pound. Since farming spiders is incredibly inefficient, scientists have been trying for decades to find a way to mass produce the material from genetically modified bacteria, yeast, and even goat milk, but these efforts have always fallen short. The biggest challenge was that the genetic information for dragline silk is a long string of repeating DNA, and, in previously tested organisms, cellular machinery arbitrarily alters or chops up such DNA sequences. To circumvent this problem, researchers precisely separated the repeating DNA into bits and inserted each repeating piece separately into bacterial genome. These smaller DNA pieces produced small peptides that ended up combining in bacteria and formed a strand of silk. The researchers also added to the end of each strand a chemical tag that glued the individual fibers together. This method was able to produce 2 grams of spider silk for each liter of bacteria and the resulting material behaved exactly like dragline silk. Its tensile strength was measured at 1.03 gigapascals, about the same as for naturally produced dragline silk. The engineered silk’s toughness measured 114 megajoules per cubic meter, compared with around 100 megajoules for silk made by spiders. And the engineered silk strands could stretch 18 percent before breaking, the same as natural dragline silk. The new silk was developed in part with NASA funding for applications such as giving astronauts a means of producing tough materials while on Mars. But the substance could be used in designing stronger materials for robotic, medical, or textile applications.

Electricity from falling snow

Ahmet A et al. All printable snow-based triboelectric nanogenerator. Nano Energy, April 2019.

Researchers have designed a new device with which we can now obtain electricity from falling snow. This new energy conversion method could become a new source of electricity in the future, especially in remote areas, as it does not need batteries. Researchers called it a Snow-based TriboElectric NanoGenerator, or Snow TENG. It is inexpensive, small, thin, and flexible like a sheet of plastic. After starting a charge from static electricity, energy is generated from the exchange of electrons. Snow is already positively charged by giving up its electrons, while silicone, a rubber-like material which consists of silicon atoms and oxygen atoms, is combined with carbon, hydrogen, and other elements to be negatively charged. When the positive-charged snow falls onto the surface of the silicone, the charges interact, and the Snow TENG captures the charge, which allows it to turn snowfall into electricity. 30% of Earth’s surface is covered by snow each winter, which is also the time when solar panels, one of the most reliable renewable sources of energy, aren’t very effective. Snow accumulation reduces the amount of sunlight that reaches the solar array, which makes them unable to operate. Snow TENG could be integrated into solar panels and provide a continuous power supply, even at a time when it’s snowing. Researchers used 3D printing to design the small device. It consists of a layer of silicone and an electrode which can capture the electric charge. Given that silicone is widely used in the industry, this method could dramatically reduce the global costs of producing electricity.

Skin is composed of two main interwoven layers of dermis, on the inside, and epidermis, on the outside. The epidermis, which is composed of five sub units, possesses the most important sign of our identity. Each thin layer is arranged in a way to carry out different tasks. A significant amount of elasticity and flexibility is provided to skin via these five layers. These layers can glide on each other slightly and can also be compressed under pressure. They are compressed when we sit on a hard surface. This situation can be similar to the compression of the spring in a click pen, or the suspension of a vehicle under a load. They regain their previous state upon termination of the pressure, like standing up. This elasticity is crucial for skin’s integrity.

The thin construct of our skin contains sweat glands that are embedded in the fibrous connective tissue. There are sensory receptors, hair roots, and hair muscles connected to them, and also loose nerve endings, and a network of capillary vessels. Free nerve endings are created to specialize in various functions so as to sense hot, cold, pressure, and pain. Likewise, the continuation of blood flow relies on very intricate calculations that are hard to explain. When blood vessels arrive at the skin, they are dispersed like a net in the form of capillaries.

The blood pressure of the arteries located at lower section of the skin is higher than the pressure of pulmonary veins. If pressure is applied to skin for a long duration from outside, the pressure in the pulmonary veins builds up and regional blood flow is disrupted. Therefore oxygen, glucose, and other nutritional substances cannot be delivered to these areas; along with inhibition of waste product removal, it leads to a nutritional abnormality in the tissue.

Sensory cells within our skin detect and report nutritional abnormalities of tissue to our brain via various chemical substances (like acetylcholine, bradykinin, and histamine). Thus we change our position consciously or subconsciously with the intervention of our brain to avoid the danger of a nutritional abnormality, and therefore the area regains normal circulation. In this stage, the process is still reversible; however, should the pressure continue, skin cells will start to die from, from the outside in. These systems do work well in healthy persons but in cases of stroke or coma, the intervention system does not work.

This critical picture can be understood better with an example. Just like roads need to be used in order to carry goods and remove trash, the transportation of minerals, vitamins, and many other life saving substances to the distant parts of the body and removal of waste products requires blood vessels to remain open. This must continue in a perfect balance without any interruption throughout our lives.

If a pressure ulcer occurs, it is like being exposed to external dangers in a house if a door or window breaks. It is like a free entrance visa is granted to germs that were blocked. Our back and pointy areas, like, thighs knees, heels, and shoulders are under more pressure, and therefore at more risk when we lie down. Two to six hours of pressure to one of these areas is enough time to disrupt skin integrity. Our daily sleep requirement is around 6-8 hours, therefore we need to switch positions a couple of times during our sleep. Therefore we face this risk everyday in our sleep; however, thanks to the perfectly functioning protective systems, without noticing during our sleep, our position is changed and this dangerous situation is avoided. Intensive care doctors and staff know better what a great blessing that is are since intensive care patients are mostly unable to move. Despite the use of many preventive efforts, like turning the patients in certain periods or the use of air beds, pressure ulcers still occur and a significant portion of patients die of the microbial infections caused by these wounds.

The story of sleepers

“The Seven Sleepers” story in the Christian tradition is retold in the Qur’an as “the People of the Cave.” The story is about a group of young believers who took refuge in a cave fleeing the oppression of the pagan Roman emperor. Both traditions narrate that they fell asleep in the cave, where they stayed asleep for hundreds of years. The Qur’anic account, however, mentions that they were made to change position during their centuries-long sleep: “You would have thought them awake though they were asleep. We caused them to turn over to the right and the left…” (18:18). It is an interesting nuance that they were made to change position, for it sounds rather irrelevant to the rest of the story. However, with the medical conditions of our skin that were explained above, this nuance makes perfect sense as advice to us on how we should treat patients who are unable to move.

Some medications are effective directly over the area they are applied to. Some however are transported to distant regions via blood flow and that is where they are most effective. Medication is either taken orally or through injection. When medicine passes into the blood stream from the place of administration, it is considered to be absorbed. A good example is the transportation of medicine into the blood stream of capillary vessels between the muscle cells when injected into muscle tissue. A drug taken orally however is absorbed through the blood vessels in the gastro-intestinal system.

For orally-taken medication to be absorbed, it should be able to dissolve in gastro-intestinal fluids. First, it is broken into smaller units due to the corroding effects of stomach acid and various enzymes are secreted, then chemicals in the drug composition pass into the gastro-intestinal fluid in a molecular form. This event resembles the dissolving of a sugar cube inside a glass of hot tea. First, the sugar cube gets broken into pieces and then dissolves. A mix with a tea spoon makes this event happen a little faster. In a similar fashion gastro-intestinal movements help with the absorption of medicine. Liquid drugs like syrups dissolve in the gastro-intestinal fluid faster since they are already in smaller units; therefore they get absorbed faster.

Drugs mostly get absorbed through the small intestine. The most important task of this organ is to enable the absorption of nutrients. It is approximately 10 meters long and 4 centimeters wide. The inner lining of the small intestine has finger-like projections called villus and even smaller projections that are located on these villi are called microvillus. One of the reasons, maybe the most important reason, why the our intestines are created in this way is that as a result, the inner surface area of intestines increases multifold. Such that the inner surface area of a human beings small intestine can increase up to 200 m2 and this greatly facilitates the absorption. These projections are made of intestinal cells.

The molecules carrying the medication reach the capillary vessels by passing through these cells and then join the blood stream by crossing through capillary vessel cells. Furthermore, intestinal cell membranes host a special protein that filters unwanted substances for the cell and returns them back to intestinal lumen. Thus these unwanted substances are excreted out of the body along with other unabsorbed matter. In the same way, some drugs are held by this protein and released back into the lumen thus decreasing absorption rate for drugs experiencing this reaction.

Liver: The organ responsible for eliminating the harmful effects of medication

As soon as medication joins the bloodstream after absorption, it is first transported to the liver. This is because pulmonary veins that collect blood from the intestines are connected primarily to the liver. One of the many functions of the liver is the elimination of harmful substances entering the body. For this reason, absorbed substances are directly sent to the liver. The liver is employed with the task of chemical conversion with these substances that are transported to it. One of the wisdoms behind liver metabolism is to reduce the effects of these harmful substances via these events and to convert them into an excretal material. In the same way, drugs are metabolized in the liver, lose their efficacy and prepare for excretion.

Many drugs interfere with each other’s metabolism. If one drug’s metabolism is inhibited, blood concentration of such chemicals increase and adverse effects of drugs become more frequent. Irresponsible drug use must be avoided for this reason. Drug interactions may lead to major damage in addition to the drug’s individual adverse effects. Moreover different nutrients also affect drug metabolism. For instance, grapefruit inhibits metabolism of certain medicines, as a result blood concentration of these medicines increase and adverse effects can be observed. On the other hand, some nutrients like broccoli, cabbage, and charcoal roasted meat speed up the metabolism of certain medicines. In this case, the blood concentration of the affected drug drops and may lead to reduced benefits from intended use. Because of this reason, patients on long-term medicine treatment should not consume these types of food.

The rest of the drug molecules that escape these metabolisms is directed towards blood vessels feeding other organs. Some drug metabolisms in the liver present individual differences as metabolic levels change from person to person. Thus, a drug with the same dosage develops desired blood concentrations for some people, fails to meet this level for others or can even cause high blood concentrations enough to generate adverse effects in other individuals. That is why a medicine that has benefited a patient should never be used by somebody else without consulting a doctor.

The function of bile

Bile secretion originating from the liver and gall bladder has critical importance in the digestion and absorption of fats. Bile breaks apart fats into small pieces so that digestive enzymes can affect them. As a result of this, absorption is provided for fats and vitamins like A, D, E, K that are soluble in fats. In a similar fashion bile improves solubility and absorption of some drugs that does not dissolve in gastro-intestinal fluid. Another task of bile secretion is the removal of certain substances from the body. Waste materials in the bile that is dumped into duodenum are excreted through the digestive track. Some drugs are excreted in this way.

Drug intake before or after meals

It is a well known practice that medications are advised either to be taken after or before meals. When medications are taken after a meal, they cause less of the possible unwanted disturbances such as stomach sickness, aches or indigestion.

On the other hand, nutrients may reduce intake of certain drugs, therefore they need to be taken before meals. However medications taken right before a meal does not apply in this case since the food will still mix with the medication in the stomach. When taking these medicines, it should at least be an hour before meals. Generally consumption of a medicine before or after a meal does not really change its absorption level. But medications taken before meals pass the stomach into the intestines without delay and therefore get absorbed faster. This practice is important in cases where an immediate effect is desired such as pain relief. Plentiful water intake also helps with faster and improved absorption of drugs.

Some medications are packed into capsules made of gelatin-like substances. Medicines with undesirable taste and smell can be offered in this form for consumption. Moreover, if a drug is harmful to the stomach or gets degraded in stomach acid, then this drug can be prepared in capsules that are durable to stomach acid but soluble in the intestines. That is why consumption of medication without its intended capsule should be avoided. In a similar fashion, some medicinal tablets are designed to deliver its molecular contents particularly to the intestines. These types of medication must be taken as a whole unit. Otherwise it can be ineffective or may lead to harmful reactions.

Delivery of drugs to targeted regions

The molecules carrying medication that join the blood via absorption get dispersed by blood circulation throughout the body. These molecules reach various parts of the system via blood vessels, and then diffuse into organs via capillary vessels. However, their entry to the brain is difficult because this vital organ of the body has a special protection to guard itself from possible harmful effects of various substances that enter the body from the outside. Capillary vessels in the brain are different from other capillary structures in the rest of the body as they are created without an intercellular space in between vessel cells. Furthermore, these cells are bound to each other with their tight connective regions.

These capillaries are surrounded by a thicker membrane compared to other capillary vessels. This membrane is also host to various cells that wrap around the vessel. Therefore, because of these factors and other similar ones, some medications can enter the brain in very limited amounts. Drug molecules can display their targeted effects when they bind to target proteins, called receptors, in the organs. These proteins, which are very unique to each drug, exist on the cell membrane or in the cell. In addition, drug molecules also bind to other receptors that are not specific for them, and this causes adverse effects as a result.

Excretion of drugs from the body

Drugs are excreted from the body via the liver and kidneys. One function of these organs is to filter the blood from foreign substances. It was previously mentioned that absorbed substances from intestines are transported to the liver first where some amount gets metabolized and the remaining amount rejoins blood circulation that feeds other organs. Drug molecules that pass through the liver return back to it repeatedly many times because of continual blood circulation. In each of these arrivals, some amount is again metabolized. Molecules of metabolized drugs are excreted out of the body via the kidneys and through the bile at a limited level.

Only some portion of drug molecules get excreted via the kidneys without being metabolized. This ratio is higher with some medications. These types of medications are considered to be removed only by the kidneys, whereas some other drug types cannot be excreted without getting metabolized through the liver. As previously mentioned, the purpose of drug metabolism is to convert drugs into easily removable forms. If these types of drugs are not metabolized, they are rejoined to the blood circulation after filtration by the kidneys without joining the urine. It is impossible for the liver to sense these happening within the kidneys if it was not that the liver and every cell in it were employed by one authority who created them in the first place. Drug molecules concentrate in the liver and kidneys since these organs are employed with drug removal. As a result harmful effects of drugs are often experienced in these organs. Therefore unnecessary drug use should be avoided, otherwise the health of these organs deteriorate and eventually fail to carry out their basic functions.

As noted above, events that are taking place within many of our organs, stomach and elsewhere like kidneys impact on the journey of drugs in our body, therefore changing its effect. The harmonious creation of our organs that are home to many miraculous events is the major component of the entire process in which causations have their due role only as much as they are allowed by their Creator. As a test for humankind, both illness and the cure is provided by God, the All-Healer. Therefore it is the duty of a patient to see a doctor, take the medication properly and never forget that cure is only provided by the Almighty, without obsessing over causational chains.

References

• Guyton, Arthur C., John E. Hall. 1991. Textbook of Medical Physiology, Saunders.
• Patton, Kevin T., Gary A. Thibodeau. 1993. Anatomy & Physiology, Mosby.
• Rang, Humphrey P., Maureen B. Dale, James M. Ritter. 1999. Pharmacology, Churchill Livingstone.
• Brunton, Laurence, John Lazo, Keith Parker. 2006. The Pharmacological Basis of Therapeutics. McGraw-Hill Professional

We vessels can be divided into three main groups in terms of structure and function. The ones with thicker walls, which bring every organ the blood they need from the heart, are the arteries. The pressure inside us is higher and we easily carry blood to the organs. The ones with thinner walls, lower pressure, and larger inner space are called veins. As a matter of fact, both arteries and veins have a three-layered structure that is very suitable for holding a fluid like blood. Since our walls are strengthened with both connective tissue and smooth muscle layers, we bear the pressure coming from the heart and help blood proceed by contracting and relaxing. Since arteries are directly subjected to the strong pressure from the heart, our walls were created in a thicker and stronger form. Since the veins return blood to the heart and thus have lower pressure, we have valves that close after blood passes, so it does not flow backward due to gravity. This is a serious challenge for the blood passing through your legs. Varicose veins might develop due to weight gain from pregnancy or obesity, which increases pressure on the legs, or to hours of standing, walking, or running on hard surfaces.

Capillaries are the most delicate blood vessels, with walls made of a single layer of epithelium, which enables us to exchange substances between blood and tissues. As blood vessels, our total length is about 120,000 kilometers. Try to imagine if a fisherman’s net were made from a rope of this length and how wide it would be! And yet, such a vast network of blood vessels is located in your body, and capillaries take blood to every part, without neglecting an area as tiny as the head of a pin.

The well-being of your organs is directly related to us. If our interiors begin to narrow, because of fatty cholesterol plaque for instance, then we begin to lose our flexibility. This means malnutrition for that organ, since a lesser amount of blood than expected can come. If a blood clot sticks to our wall and blocks the blood flow, the relevant organ may be in terrible trouble. If other arteries supply blood to that organ, then it can handle this, but if a main artery is blocked and if secondary channels do not exist or are insufficient, you experience infarction. Taking this into consideration, you need to be careful what you eat and lead a physically active life. When you get old, if sufficient blood does not pass through us in your brain, failures with brain activities appear and you go senile. As the walls of veins and arteries have a rich network of nerves, we let the suitable amount of blood flow according to the need of the organ we’re serving, under the control of the autonomous nervous system. While blood vessels that are connected to an organ not currently requiring much blood contract to reduce the amount supplied, those that are connected to currently more active organs expand. And dear Peter, the greatest blessing here is that none of these activities require any conscious effort from you; everything works smoothly without your even being aware.

This wonderful network of ours finds its value in the vital fluid we carry. If it weren’t for blood, we would have no value at all, and such a perfect means of distribution would be unnecessary. Even the duty of the heart is to make this fluid circulate throughout the body. Now, let us step aside and allow blood to have the floor.

The muscle cells are responsible for the strength and tone of the vessels. Today, we know that the role of the endothelial layer goes beyond a simple physical barrier. In addition, there are twenty-five different substances secreted by the endothelial cells that play a role in blood clotting, cell proliferation, the regulation of vessel permeability, and the functioning of the immune system. The endothelial cells are 10-15 &μm wide and 20-25 μm long. They are located in the inner vessel wall in a single-cell layer. The total endothelial area in the body of an adult is around 5000-6000 m², and it weighs around 2.5 kg. Endothelial cells during inflammation Capillaries consist of an endothelial structure; they can only be seen under a microscope, but their total length is nearly 96,000 km. The blood brought by the arteries is conveyed to the vein through capillaries. At this stage, the gas, liquids, and nutrients are brought out through the vessels and the cells and tissues around are supplied with oxygen and nutrients. In return, the liquids that they discharge and other waste matter are conveyed to the vein through capillaries. This matter-exchange, which occurs both inside and outside of the capillaries, is regulated thanks to the permeability of the endothelial cell layer and the pressure balance of the capillary system. During cardiac failure and inflammation, liquid release is increased due to a pressure imbalance and the liquid retrieval is not sufficient to make up for the amount lost. This results in swelling in the area in question. Here, we need to underline that inflammation, which appears with symptoms such as edema, redness, fever, and pain, is not a harmful process. On the contrary, it is a miraculous defensive mechanism granted to our body; inflammation protects the body against serious damage. For instance, the inflammation that forms around a bee sting prevents the venom from spreading throughout the body. The endothelial cells are given an important role in the inflammation as well. The chemical molecules secreted by the endothelial cells in the inflamed spot cause the vessels to react by enlarging and thus perfusion is increased. Later, the endothelial layer becomes ready for leukocytes to settle; these are used in neutralizing the substance that caused the inflammation in the first place.

Balancing blood pressure

The layer of smooth muscle cells is stimulated with chemicals secreted by the endothelial cells and the tone of the vessels are controlled through the constriction and relaxation of the vessels. Therefore, an important duty in the regulation of blood pressure is given to these cells. During aninfection, bacteria circulate in the blood stream and the blood pressure falls extremely low. Tissue nutrition is upset (septic shock) and an excess of muscle-relaxing substance is released by the endothelial structure. Veins and arteries become too relaxed and there is a considerable drop in blood pressure (hypotension). On the other hand, with problems like atherosclerosis, the endothelial cells cannot fulfill their duty and due to a deficiency in nitrogen oxide, they become immune to the stimulus to relax the muscles. The resulting problem in this situation is hypertension.

Endothelial cells prevent hemorrhage

In order for a hemorrhage to stop the vessels that are bleeding need to narrow down. This is very important in the first stages of blood loss, particularly when there is a problem with blood clotting. When a hemorrhage begins, the endothelial cells are ordered to excrete a substance called endothelin. This starts the narrowing down of the bleeding vessels. Endothelin is not excreted in normal vessels. When the umbilical cord of a newborn is cut, it prevents the baby from losing blood.

Endothelial cells in blood clotting

The duty of endothelial cells can prevent or facilitate blood clotting, depending on the situation. First of all, they prevent the blood cells from adhering to the vessel walls and prevent clotting inside the vessels. Imagine water flowing through a pipe. The speed of the flow is greater in the center and lower at the periphery. Therefore, in the long run, some residue forms inside the pipe. In the veins and arteries, the flow of blood near the walls is also slower. To prevent the formation of any residue, both the endothelial cells and the blood cells are created with negative loaded surfaces and the blood cells are pushed towards the center. In addition, a substance called prostocyclin (PGI2) is excreted and the thrombocytes change their structure. As a result, residue formation and clotting is prevented along the vessel walls. In a case of any long term damage to the endothelium (e.g. due to smoking, diabetes, or hypertension), the relevant protection mechanism fails, and clotting inside the vessels results in thrombosis. Some serious cases can even necessitate the amputation of a limb. The endothelial cells can also facilitate clotting when necessary. In case of bleeding due to a wound, they function contrarily and help the blood to clot to prevent blood loss.

Endothelial cells in the bone marrow, the liver, and spleen

As a divine blessing, the endothelial cells form a looser layer in these organs and vessel permeability is increased. Thanks to this increase, matter Exchange with blood is easily realized; blood reaches these organs, which are responsible for the constant control of the contents of the blood, easily.

Endothelial cells in the brain and eyes

The endothelial cells in organs like the brain and eyes are very closely integrated forming a barrier between the blood and the organs. This is to such an extent that the major nutrients of the brain, like glucose and oxygen, pass without any obstacles, but several chemicals, including medication, are blocked by the selective-permeability of this protective mechanism. Research has proven that various substances injected into the bloodstream reach almost all the tissues except for the brain. Thanks to the efficient protective mechanism that has been given to these minute cells, the brain is saved from a great deal of negative effects. Even a single cell is not left to chance and nothing happens randomly. As can be seen throughoutthe universe, opposites are made to work hand in hand in the human body as well in a splendid harmony for the continuation of life.

References

• Vinay Kumar, Abul K. Abbas, Nelson Fausto, Richard Mitchell, Robbins Basic Pathology, W.B. Saunders; 8th edition, 2007. Hall, John E., Arthur C. Guyton, Textbook of Medical Physiology,

Hypertension is one of the most widespread dangerous diseases of this century affecting the young as well as the elderly. It can lead to other, more dangerous conditions, coronary and brain diseases among them.

The two main causes of hypertension are stress and being overweight conditions associated with the life-style of the materially wealthy, industrialized nations. (We may note in passing that Islam forbids excessive consumption whether in or in goods, and it requires the believers to halt their daily routines at least five times a day for prayer – and prayer, standing or sitting in the presence of the All-Mighty, gives due proportion to all human affairs, enabling the worshipper to obtain or recover calm of body and mind.) .

Doctors nowadays recommend patients with hypertension to eat less salty foods, to avoid becoming overweight and to keep fit by doing light but regular, frequent exercise. But; before that, doctors ask them to give up drinking and smoking if they indulge in these habits. (Again, we note in passing that the life-style being recommended makes up a prescription as familiar to Muslims as the Qur’an and Sunna.)

Hypertension adversely affects blood pressure; to keep the pressure at normal level, the blood vessels constrict. That constriction may, in turn, cause damage when it passes beyond certain limits. It can overload the heart, soon leading to coronary vascu1ai diseases. On the other hand, excessive blood pressure not reduced by constriction of the blood vessels may damage the vessels and, subsequently, lead on to brain and liver diseases.

The first measurement of human blood pressure was taken in 1834. An apparatus like the type most commonly used today was introduced in 1896, with some operative improvements in 1906 (Weinstein, 1976). We meet the first accurate descriptions of what we now know as ‘essential hypertension’ in a series of clinical papers by F. A. Mohammed between 1874 and 1881 (Page, 1988).

It comes as a surprise to learn that hypertension was first recognized as a serious health problem only in the late 1930s. During the 1920s, the textbooks used in leading medical schools throughout the world made no mention of hypertension as a problem, let alone as a disease. The association of hypertension with stroke, heart failure and renal failure was still nebulous (Page, 1988).

A research group under Irvine Page were trying to demonstrate the connection between hypertension and coronary heart diseases and to convince the authorities of the time about the importance of treatment for hypertension. When this group announced, with another group of researchers, that they had found a hormone which is very important in the regulation of blood pressure, there was little or no interest. Page’s group had named the hormone ‘angiotonin’, while the others had named it ‘hypertension’. The two groups got together and agreed on the name ‘angiotensin’ for the hormone. Page suggested that angiotensin was one of the important factors in blood pressure regulation. The active form of this hormone, Axigiotensin-2, caused the blood vessels to constrict so that the blood pressure could be kept at a certain level. Therefore, hypertension could be relieved by preventing the synthesis of this hormone.

As the years passed, the number of researchers and organizations working in the field (as well as funding) increased dramatically. Drugs like ‘captopril’ and ‘enalapril’ were developed, which would block the production of angiotensin and hence give some temporary relief to sufferers of hypertension. Today, hypertension is a major medical research area usually carried on under the broad category of brain and cardiovascular research.

When Dr Ibrahim Benter, A Muslim chemist and doctor, came to the Cleveland Clinic to work as a research scientist. Dr Ferrario was the head of the brain and cardiovascular research department. Having worked with Irvine Page at the Cleveland Clinic earlier, Dr Ferrario had been interested in angiotensin for several years.

He had previously shown that Angiotensin 1-7 a trimmed version of the hormone Angiotensin-2, was synthesized in various sites in the human body. However, he was somehow unable to show its effects via live-animal experiments. Despite his reputation, his articles on this particular subject were rejected everywhere. One reason for this was the consensus of the research community that submolecules of Angiotensin-2 were ineffective. After several years of fruitless research, Dr Ferrario had begun to lose hope.

The story of Angiotensin 1-7 attracted Dr Benter’s interest. He had a simple and sound principle: ‘The All-Mighty would never create something that is useless.’ Since angiotensin was synthesized in various places in the body, it should have a definite function. He decided to do some experiments in his own lime during his stay in the Cleveland Clinic. When he mentioned his idea to colleagues some of them smiled and told him not to waste his time. Briefly, they were saying ‘We spent several years and got nothing out of this research; you should not make the same mistake.’ Everybody seemed to have convinced themselves that Angiotensin 1-7 was useless.

However, Dr Benter was determined. He began his experiments using his own set-up and techniques in the expectation of turning up something missed or neglected in previously used methods. Dr Ferrario, having noticed Dr Benter’s efforts, visited him from time to time to see if anything new had turned up. When several trials yielded no positive findings, Dr Ferrario gave up all hope. Not so Dr Benter. I us determination was grounded on his belief that all scientific research is like a prayer to the All-Mighty, and that discoveries are part of the results of the acceptance of these prayers. Since God is the One who makes all progress possible our duty is to work with faith in a systematic way.

Shortly afterwards, he received the reward for his patience, faith and determination. Angiotensin 1-7 was not useless at all. It was a hormone with a function of profound importance – it was just that certain mechanisms in the body hid its effects from being easily observed. When he determined those mechanisms and disabled them, he clearly observed the effects of Angiotensin 1-7. The results were very significant. When acting alone, Angiotensin 1-7 lowered the blood pressure considerably; it could therefore be used as the basis For a new medicine against hypertension, one with fewer side- effects (sec Renter. 1992).

On learning about Ibrahim Benter’s findings, Dr Ferrario gathered all the researchers in the department in Ibrahim’s lab: he wanted them all to see the results. As his colleagues watched the gauges with awe and surprise. Ibrahim was silently thanking his Lord for the success He had bestowed.

They quickly prepared an article, sent grant proposals to relevant institutions and requested support for further research. The response was positive. They were given a research fund of approximately 1.5 million dollars to continue their study. When the official from the funding institution visited them, he said privately to Ibrahim Benter ‘without your findings, this grant would not be possible’.

Dr Ibrahim Benter is probably even now continuing his research on Angiotensin 1-7. When interviewed on the subject, he explicitly asked the following comment to be made public:

This achievement, for which many other more experienced and skilled researchers worked fruitlessly was made possible only by God’s help.’

The story we have just told, is perhaps one example among countless others which demonstrate the role of faith and determination in achievement. If it was successful in bringing an important fact to our attention, or refreshing our confidence in it, then our telling the story has served its purpose. 

REFERENCES

• BENTER IBRAHIM (I 993) ‘Cardiovascular Actions of Angiotensin 1-7’, Peptides, Vol.14. pp.679-89
• PAGE, Revise n. (1988) Hypertension Research: a memoir. Pergamon Press. NewYork.
• WEINSTEIN, MILTON C. (1976) Hypertension: A Policy Perspective. Harvard University Press. Cambridge MA.

The field of medicine, as one of the oldest fields of scientific inquiry, has been particularly rich in examples of changing theories. Aristotle (384-322 BC) thought that the brain was a device used for cooling the blood. By contrast his teacher Plato (427-347 BC) had thought that it was the ‘originating power of the perceptions…’ Yet today scientists accept Plato’s older theory. In the 1800s the state of the art brain science was phrenology, attributing certain aspects of human character to bumps and ridges on the skull. This is frowned upon today as mumbo-jumbo. However, it must be remembered that at the time it was considered as a hard and fast observational science. It was not until 1861 that Paul Broca refuted this ‘science’ by attributing language to a certain region of the brain, since referred to as Broca’s area. Even so, phrenology continued to have its adherents and practitioners until the early 20th century. Many of the current theories of thought, emotion, psychology and psychiatry are based on observations only slightly more reliable than those made by the phrenologists. The tools used are more expensive (e.g. CT, M RI and PET scanners) but the basic approach is comparable to that of the phrenologists.

Currently a revolution is taking place in biomedical science. ‘This revolution centres upon (aptly named) free radicals’. The most famous of these is nitric oxide (NO).

Nitric oxide is a noxious chemical spewed out by car exhausts and power stations. For years it was considered to be one of the most poisonous gases known to man. However, in the 1980s scientists discovered that many cells of the body also produce nitric oxide. Hundreds of research papers have been produced in recent years investigating this short-lived compound. It is currently a more popular research topic than AIDS, Alzheimer’s and arthritis. NO has revolutionised scientists understanding of blood pressure and the whole manner by which cells communicate.

It is thought that when released by the body in minute amounts it is capable of carrying biochemical signals from cell to cell resulting in a whole array of bodily events. In circulation NO helps to control the bore of the blood vessels and hence blood pressure. In the nervous system it is thought to be implicated in memory. In the immune system it purges both foreign bodies and tumour cells. The medical profession have realized NO’s importance in many conditions not just high blood pressure but also stroke, septic shock, clotting disorders and even impotence.

The mode of action of NO is its most controversial aspect in terms of traditional understanding of cell biology. To start with NO is what chemists call a free radical. This means that it carries an unpaired electron and is therefore highly reactive, unlike any other molecules in the body’s well- documented and well-balanced signaling system. NO liberated from cells is converted within a split second to nitrogen dioxide NO2 by combining with oxygen. Most of the both’s other communication molecules are complex by comparison, molecules such as amino acids, catachol amines and small peptides. These conventional message transducers deliver signals by latching on to specific receptor molecules. A classic example is the catachol amine adrenaline latching onto beta receptors. This is usually described by a lock and key analogy. The mechanism of NO goes against this completely by penetrating cells directly. Once inside cells it stimulates the production of a small nucleotide called cyclic guanosine monophosphate or cGMP. This cGMP induces a host of functions ranging from muscle relaxation to slowing down blood clotting.

The importance of NO was first discovered in the regulation of blood pressure. NO was found to cause blood vessels to dilate by relaxing the muscles in the vessel walls. Blood vessels are made up of layers of muscular, elastic and fibrous tissue, and have a lining called the endothelium. The endothelium releases NO which drifts into the surrounding layer of muscle. There it triggers the events that make the muscle relax at the diameter of the vessel then widens. This process is controlled by the mechanical effect of the blood flow. When blood rushes over the cells of the endothelium it causes them to distort slightly. This distortion results in the release of NO. From this it can be seen which in turn sends messages to the vessel walls via a whole arm of receptors and transmitter muscles. The balance between the central nervous control and local control is not well understood. For years doctors have used drugs that affect the nervous control to lower blood pressure with apparent success, for example beta receptor blockers. However the result of the various NO experiments indicate that the nervous system is comparatively insignificant in the regulation of blood pressure. The mysteries of beta-receptors and there complexities are far from solved, yet these are supposed to provide the scientific bases of high blood pressure tablets, such as beta blockers. ‘There must be a continued balance between these two powerful forces. – the local vasoconstrictor control and the central vasoconstrictor control.’ says Sir John Vane, of the William Harvey Institute, London.

The theories of circulatory control have been revolutionized by one man. Salvador Moncado, who first documented the role of NO in blood pressure and clotting: ‘We worked for hundreds of years thinking that the arterial system is a system of resistance vessels, when conductance is probably the better concept to use – which is the inverse of resistance. ‘This has resulted in a conceptual reversal of all research in the field of high blood pressure. The novel theory has cast doubt on the mechanisms of all the blood pressure lowering drugs that have been used, and yet these drugs do appear to work. This has parallels with the use of the drug aspirin, which has been used for decades for various ailments, but theories of its mode of action were only documented in the late 1970s. What came first – human theories or the practical results? A current controversy is whether we should consider high blood pressure to be the result of too much adrenaline or too little NO.

Doctors have unknowingly utilized the NO system for years. Since 1867 amyl nitrite and nitro-glycerine have been used to relieve the horrendous heart pains experienced by sufferers of angina pectoris. Doctors knew that these nitrogen containing drugs dilated blood vessels and reduced blood pressure. But the exact biochemical Involvement in scientific research should always convince us that humankind has a very limited understanding of the universe and that most of the work done by us only involves giving names to existing phenomena.

Examples of this are not only confined to biology. A recent discovery has rocked the world of cosmology, with much more importance to Muslims. The data that have come back to earth from the Bubble telescope suggest that the universe is only 8 billion years old. Scientists consider these to be the most reliable data involving the most elaborate experiments performed by humans on this subject. Yet Big Bang theory calculations tell us that the universe is no younger that 16 billion years. The best real data tell us 8 billion years: the calculations from theory tell us 16 billion. The inadequacy of theories could not be more dramatically demonstrated.

O believers, when you stand for prayer, wash your faces, and your hands up to the elbows, and wipe your heads, and wash your feet up to the ankles. If you are unclean, bathe and purify your bodies fully. But if you are ill or in the middle of travelling or … you cannot find water, then take wholesome dust and wipe your faces and hands with that. For Allah does not wish to burden you, rather He desires to purify you and to complete His blessing and favour upon you so that, perhaps, you may he grateful.[5:6]

Here is a grand prescription from among the many marvels of the Qur’an. The day will come when even non-Muslims will imitate the Muslim wudu or washing before prayer, a privilege and favour Muslims have enjoyed for more than fourteen hundred years. And they have done so, more or less, unawares, as it is only through the discoveries of biologists in the last twenty years that we have come to understand fully the wonderful effects of wudu. The three principal benefits that human health derives from washing are related to the circulatory system, the immune system, and the electrostatic balance of the body.

a) The circulatory system

The circulatory system is twofold. First, the heart pumps blood out to the tissue cells in every part of the body. Second, it collects back the biologically used blood. If this reverse circulation in particular is disturbed, diastolic blood pressure increases and ageing, even the onset of death, may be precipitated.

The healthful condition and functioning of the blood vessels is essential to this twofold circulatory system. Blood vessels resemble flexible tubing, dividing into thinner branches as the distance from the heart increases. If the thinner tubes in particular become hardened and lose their elasticity, pressure and workload upon the heart are increased. This is known in medical jargon as arteriosclerosis.

Various aspects of our lives cause the blood vessels to harden and become constricted. This problem, considered to be the basis of ageing and bodily deterioration, is now a distinct field of medicine on its own. Improper nutrition and nervous reactions can have a serious effect on the condition of the blood vessels. If sclerotic development is observed in a blood vessel, what practical measure can be taken against it?

The hardening and narrowing of blood vessels does not happen all at once, but over a long period. The vessels furthest from the heart, such as those in the brain, feet and hands, are more vulnerable to the process which begins slowly in these locations and goes on continuously with the passage of time. However, there is an application in our daily routine which, in a sense exercises blood vessels by alternately contracting and dilating them. Its agent is water, which gives rise to temperature gradients. Water ensures flexibility and visor of vessels distant from the heart by dilating them when hot and contracting them when cold. It also forces nutrients, deposited in tissues as a result of sluggish circulation, back into the bloodstream by virtue of the temperature difference.

In view of these facts, is it possible to understand the verse commanding Muslims to wash the hands, feet and face in the wudu rite as anything short of a marvel, particularly in the light of the conclusion of the verse: He desires to…. complete His blessing and favour upon you. Circulation of the blood is a favour to us from the Creator. The command to do wudu completes that favour by maintaining the blood vessels and the circulatory system generally in a healthy state. This is the first of the many blessings of wudu. It is impossible to deny the fact that washing protects against senility which is the way the hardening of blood vessels reflects on the circulation in the brain of a person who has been doing wudu regularly since childhood.

b) The immune system (lymphatic circulation)

In addition to the circulation of red blood cells in the body, there is also the circulation of white blood cells or leucocytes. The vessels of this system are ten times thinner than those which conduct red blood cells. We sometimes see its colourless fluid oozing from the skin walls in some abrasions or wounds. It is this lymphatic circulation which keeps all points of the body within the protection of the immune system. Any bacterium, alien object, or cancer cell (the cause of which is not known), which may have invaded the body is destroyed by the warrior cells or leucocytes in the lymphatic circulation. The appearance of an infectious disease or cancer in the body is always contingent on the malfunctioning of the immune system.

Exactly how this system of vessels expands and contracts has not yet been fully clarified. It is known, however, that heat and cold influence the system. Catching an infectious disease such as a common cold is ascribed to the inability, due to contraction of these vessels, to dispatch leucocytes in sufficient numbers to the afflicted area. Now the proper functioning of this system and its thin vessels, like that of the circulatory system in general, is closely linked with the invigorating effect of washing. The structure of the immune system, which provides resistance against all diseases, is reinforced through the wudu, and the divine favour mentioned in the verse is realized.

Now someone might claim that, while the lymphatic system is indeed invigorated by washing, it is just a coincidental and unintended side effect. However, the precise form of the command to do wudu disposes of this incorrect claim. I would argue, on the contrary, that the way in which the wudu is commanded to be done specifically aims at the lymphatic system as well. The reasons are as follows:

1. For the lymphatic system to function properly, even a single point in the body must not he neglected, which is assured by the full ablution or ghusl.

2. The most important centre for stimulating the lymphatic system is the nasopharyngeal region behind the nose and tonsils, and washing these spots is especially enjoined.

3. Stimulation of both sides of the neck has great influence on the lymphatic system, and this is also present in the wudu.

The most formidable warrior cells of the body, the lymphocytes, are transported to the farthest reaches of the body and, after passing through intensive biological training, patrol each point in the body many times a day. If they meet a bacterium or a cancer cell, they destroy it. Is this not a divine blessing of the first quality? If a circulatory disorder occurs once in a while and you are able to avert or mitigate its effect by means of regular wudu, is it not proper to regard the command as the promised fulfilment of divine favour for which mankind are required to give thanks?

c) Static electricity

The body normally has a balance of static electricity, and the physiology of a healthy body is closely related to this electrostatic balance.

Atmospheric conditions, as well as plastic clothing and products common in our time can adversely affect this balance. Painful illnesses, irritability and facial wrinkles are the best-known results. Most of us have become aware of this electricity when climbing out of a car or after sitting in a plastic chair. Stormy weather has a comparable effect. Healing by acupuncture and, in certain respects, physiotherapy, can redress this imbalance of static electricity; but we can avoid the effect entirely, simply by doing the wudu several times a day.

There are many psychosomatic illnesses arising from electrostatic imbalance. I shall not dwell on these here. I shall address only the question of skin care, which has become such a fashionable subject now.

The worst influence of static electricity is exerted continually on the small subcutaneous muscles (under the skin), finally rendering them inoperative, which is why wrinkles set in, starting with the face, though the skin is affected over the whole body. At this point, many of my readers will have divined at least one of the reasons for the radiant appearance of those who have done wudu all their lives. Whoever maintains the habit of regular washing inevitably has the more healthy, and therefore the more beautiful, skin. How remarkable it is that in our time, when millions are spent on cosmetics, a tenfold increase in expenditure would still not properly substitute for simple washing.

Doubtless, the sceptic will ask, but does wudu really have anything to do with static electricity?

Of course it does. The part of the verse pertaining to tayyamum when water is not available for wudu, underlines the fact. For this substitute for wudu also disposes of static electricity to a significant extent. Indeed, the importance of it has hitherto gone unrecognized, and no-one has tried to explain why, tayyamum can take the place of wudu when the necessity arises.

As the verse clearly states, the sanitary aspect of wudu is a great blessing which we can now partially explain in medical terms. A person might well say: But I already wash my face and hands anyway. Let us recall, however, that as a widespread public habit, this practice has a very short history (barely seventy years or so) even amongst nations who have a tendency to claim to be the most civilized in the world. More important, cleanliness based on a sort of general good advice can never be sustained with the steadiness of discipline which, in Islam, it has by virtue of its association with worship.

To be sure, the worth and significance of wudu does not end with these medical observations the sense of well-being and dignity derived from wudu also contribute to the general health of the practising Muslim but here my aim has been to make widely known precisely those additional medical benefits.