MEDICINE IN ISLAM
In the Muslim world today we find hospitals that more or less adequately meet international medical standards. Alongside this medical system, which we may call "Western", we find a traditional medical practice based either on ancient secular medical knowledge or popular religious beliefs and practices. People try one system or the other or both, depending on convenience and, above all, on their lack of complete trust in or patience with a single system.
The first part of this paper is a historical and theological analysis of Muslim attitudes to medicine. The second part examines the concrete forms of religious medical practice among Muslims in Nigeria.
Medicine in early Islam
Early Muslim attitudes to medicine are part of their attitudes to science and the world of nature in general. Determinism was ingrained in pre-Islamic Arabian thinking. The Qur'ān theologized about this question, affirming that God, and not an impersonal force, is master of the universe. There is still avid debate on how far the Qur'ān is deterministic in outlook. Verses can be cited for both divine determinism and human free will, but the fact remains that a deterministic attitude was preponderant in early Muslim society. It dominate Qur'ān interpretation and the development of „adīth and eventually gave rise to the occasionalism of Ash`arism, the dominant school of Sunnite theology. (1)
Medicine based on Greek science
From the 2nd century of Islam, the Muslim world was confronted with a new world of learning and culture among the conquered peoples. As for the sciences, much observational data was taken from the Persians and Indians, but the main scientific input came from the Greeks. The impact of contact with Greek science is difficult to overestimate. It constituted a social and an intellectual challenge that has remained with Islam to this day.
As a social challenge, Greek science was a threat to the Arabs' sense of superiority and self-sufficiency, an attitude which was characteristic of pre-Islamic times and was retained with the adoption of Islam. Joining Islam meant new beliefs and religious practices and membership in a community which commanded total commitment and loyalty precisely because it meant acceptance of a world view based on the Qur'ān. This world view comprehends all life values and is the reference point for all judgments. The most amazing effect of the early conquests of Islam is not the military success or the number of conversions made, but the total transformation of the intellectual outlook of the converts. (2)
As an intellectual challenge, Greek science to which the Arabs were exposed was diametrically opposite to Arab occasionalism. It presented a complex world of concatenated causes; there was room, of course, for a first cause standing outside the universe, but above all this world was itself brimming with power. The occasionalist world of Ash`arite mainstream Islam can have nothing to do with a world of nature and its spontaneous activity dictated by laws of inborn finality. The Ash`arite world is one of dimensionless atoms moving or resting in a void according to the direct command of Allah. Allah acts in a customary way, which is predictable within a certain margin, but he is bound by no law and can change his way of acting at any time.
By and large, therefore, the Muslims shunned the culture and learning of the people they had conquered. The few who ventured to investigate these matters incurred disapproval and were considered dubious Muslims. The interest in Greek science might have died with a few brave individuals if some pragmatic caliphs had not thrown their own weight in support of this movement. The caliphs' reasons sere simple: 1) Science was a practical necessity for administration, building and technical arts, military superiority and, above all, health. Let the religious scholars find reasons for approval. But even if they did not approve, the caliphs were going ahead to patronize the sciences. 2) The caliphs, moreover, found that by patronizing secular learning they got the political support of a wide class of people, including the Persian civil servants, who were attached to their traditional culture. These enabled the caliphs to act independently of the religious scholars who, as a body, felt responsible for pronouncing what the caliph should or should not do, according to their interpretation of Sharī`a. 3) Another incidental reason why some Muslims wanted to study Greek science and philosophy was to bolster their position in debates with Christians, since Christians used philosophical learning to explain and defend their dogmas; so Muslims felt on the defensive until they could reply with the same type of arguments.
It is not for us here to trace the story of Muslim theology and Muslims involvement in philosophy and science. We should only note first, that after 849 both philosophy/science and theology prospered, but each in its own separate realm, with virtually no mutual influence. Secondly, a crises developed between the philosophers and the theologians because of some of the philosophers' radical teachings. For instance, for Muammad ar-Rāzī (d. 923 or 932), philosophy takes the place or religion, since if we use our reason prophecy is unnecessary. For al-Fārābī (d. 950), God, being a spirit, could know only the general natures of things, and not particular individuals or events, whose singularity is accessible only to the senses. For Ibn-Sīnā (980-1037) God created out of necessity and from eternity. Moreover, following Plato, since human happiness consists in the soul's release from the body to return to the purely spiritual world, the resurrection cannot be literally true, since it means a return to the prison of the body; so it must be interpreted as a metaphor. Again, Ibn-Sīnā thought that Qur'ānic language, which is so metaphorical, is studied only for ignorant people; theologians go one step higher by trying to understand the deeper meaning of Qur'ānic language, but the philosopher stands at the apex of human understanding. A prophet would seem to be inferior to a philosopher, but Ibn-Sīnā sometimes explains prophesy as an exalted form of human philosophical thinking.
Ordinary theologians fumed at these excesses of the philosophers, but al-Ghazālī (1058-1111) led the major counter-attack. His Tahāfut al-falāsifa (Inconsistency of the philosophers) and other writings turned not only against the errors mentioned above but also against an underlying principle of all the philosophers: that of natural causality. Al-Ghazālī's attack on philosophy was one of the chief factors leading to a slump in the philosophical/scientific movement lasting for many centuries.
In his Iyā' (3)al-Ghazālī sorts natural science into three types: 1) false, such as astrology and magic or any science that assumes that there is causality in nature, 2) useless, namely, detailed knowledge of the physical universe, and 3) useful, of which the sole example is medicine.
Medicine escaped the censures of the theologians not because of its theory, which presupposes natural efficiency just as much as any other part of natural science, but because of its practical necessity.
Throughout Islamic history medicine has been a specialization of the Christians or Jews living in Islamic lands, but Muslims were encouraged to take an interest in hospitals and promoting research. Remarkable studies of anatomy were made, even with the handicap of not being permitted to make autopsies or dissections. More time was devoted to pharmacology and the diagnosis of diseases, and in this area the medieval Muslims went far beyond the ancients. (4)
Classical Islamic medicine followed the ancient Greek theory that health consists in a balance of the elements of the body in certain proportions. As for the agents of preserving or restoring this balance, the Muslim physicians very pragmatically prescribed regulation of diet and exercise, and freely made use of whatever discoveries had been made of the properties of plants and minerals and their artificial combinations.
Non-scientific and religious medicine
The physicians did not disdain astrological, alchemical or numerological speculations that did not have a scientific foundation. Al-Ghazālī related the following example who they used a numerical square to help a woman deliver her child:
On two pieces of cloth untouched by water is drawn a figure consisting of nine squares with a number in each, so that the sum of each row or line, vertically, horizontally and diagonally, is fifteen. The woman looks at the cloths and places them under her feet, and at once the child emerges. (5)
Religious scruples prevented some Muslims from freely making use of secular medicine, and to cater for them secular medicine was sometimes distributed in a religious packaging such as "prophetic medicine" (a³-³ibb an-nabawī), or medical prescriptions in the form of „adīth.
In addition, writers with a Ŗūfic bent, such as al-Ghazālī and Ibn-`Arabī, gave importance to the symbolism of the parts of the body and their correspondence with various parts of the cosmos. This was sometimes associated with the pseudo-scientific speculations mentioned above. Popular Ąūfism has always bordered on magic. (6) Ąūfic leaders often run a brisk business in dispensing amulets and prescribing other religious medicine. Amulets contain verses from the Qur'ān, as well as numeric squares of 9, 16 or more spaces, whose letters or numbers are supposed to add up to one of the divine names. They also contain figures of animals, names of exotic angels, planets, the days of the week, human virtues or vices and various nonsensical inscriptions. I will examine some examples of these in the second part.
I can conclude this survey with the observation that in the Muslim world there has been great tolerance toward adopting the latest in secular medical practice. Yet for many Muslims this is not good enough, and they must have religious medicine. This has ensured the survival of many ancient medical practices under the cloak of prophetic medicine. It has also given rise to magical medicine usually dispensed by Ąūfi practitioners.
Islamic medicine in Nigeria
It took a long time for Nigerian Muslims to accept modern medical care, but in seems to have taken firm root by now. Yet some medical practices common in the Middle Ages still survive. An example is the once universal practice of cupping, or periodic blood letting to relieve the supposed over-supply of blood. As late as 1886 the Constitutions of the Dominicans, a Catholic religious order, prescribed blood letting (minutio) four times a year if the brothers found it helpful. One can still see this practice in the North of Nigeria, where a cow horn is used to drain blood from an incision in the person's back.
The use of amulets is also extremely common in Nigeria, even though it is under strong attack from fundamentalist groups such as the Jamā`at izālat al-bid`a wa-iqāmat as-sunna, usually referred to as the Izala. Because of the importance and interest of amulets, the rest of this paper will examine a few that circulate in Nigeria.
A "pacts of Solomon" amulet
One amulet which I obtained is a single sheet of pater, beginning with a design in the shape of a tower which contains three numerical squares of 9 spaces each, one of 16 spaces and two of 25. Around these squares are names of angels, the first four caliphs and some of the Companions of Muammad.
The central part of the amulet contains the seven pacts of Solomon, which Amad al-Būnī (d. 1225) also describes in his Shams al-ma`ārif (7) The introduction of the amulet promises:This amulet is wonderful and of proven power, containing the seven pacts made to Solomon. Anyone who carries it will be safe by its baraka from every distress... on land or sea, while traveling or staying still. It also contains blessed signs of protection, useful for driving away sicknesses and weaknesses; the seven saving signs that are useful for driving away accidents and evil intentions of enemies and stubborn people, for defeating the envy of envious people, the grasping of the unjust and the abuses of calumnious people; the blessed key signs that are useful for making difficult things easy, lightening burdens, making merchandise sell and attracting customers, and for facilitating the marriage of an unappealing daughter; signs for bringing pregnancy, victory, making peace, compassion, love and acceptability, treating wounds and other important advantages - by the help of God.
The document goes on to explain the pacts made to Solomon: Solomon once met a most horrible looking old woman and asked her, "Are you a human or a jinn, since I have never seen anyone more ugly than you?" She answered him:I am the mother of the children who rule over the sons of Adam and the daughters of Eve. I enter a house and cry in it like a cock, or bark like a dog, or moo like a cow, or bray like a camel or a horse or a donkey, or hiss like a snake. I take any shape and clog wombs and snuff out the lives od children without being detected. I come to a women, clog her womb and tie it well, so that she will not conceive and will be barren. I come to a pregnant woman when she conceives a child in her womb and I breath on her and she aborts it, and her womb is unable to hold a child. I enter a girl or a woman engaged to marry and complicate matters and announce doom to the prospective husbands. I come to a man and drink his white heavy semen, leaving him only thin dark water and he become sterile, unable to have a child. I enter a trader and upset his business and he makes no profit. I enter plowed land and breath on it and it yields no crops or fruit. I come to children and send them severe stings and sharp pains, so that their bones tremble and their appearance becomes ugly.
Solomon then grabbed hold of her and told her, "Accursed one, you will not get out of my hands until you make a treaty with me with stipulations on behalf of the sons of Adam and the daughters of Eve." She said to him, "Prophet of God, I make the treaty with the stipulations that I will not come near or harm any man or woman or boy or girl for whom you write these pacts and he or she carries it. The same holds for any place of business or farm or animal or any possession." So he said, "Give me these pacts". So she went on to make seven pacts, sealing each with a talisman. Each pact contains a variant description of God, by whom the woman swears a solemn oath not to hurt the bearer of the charm in any way, as each oath variously describes. The conclusion of each pact is a talisman matching those of al-Būnī. At the center of a circle is a nonsensical symbol. At each corner is the divine name corresponding to the respective pact. The seven divine names are: Fard (alone - not a Qur'ānic name), Jabbār (mighty), Shakūr (thankful), Tawwāb (converter), Åāhir (manifest), Khabīr (knowledgeable), Zakiyy (pure - not a Qur'ānic divine name). (8)
Following the pacts of Solomon, the amulet contains some prayers and a melange of Qur'ānic verses, then three illustrations of advantages of the amulet: for victory over enemies (with a drawing of a sword), for protection against scorpions, and protection against snakes and accidents.
The amulet concludes with the promise: "Anyone who writes the following talisman on a paper and carries it on his head will have his headache disappear. And if he puts it on any part of his body the pain will disappear, by God's permission." The talisman is as follows: "In the name of God the merciful and compassionate: Go away, o pain, by the power of TA MIR and by the power of H H H A H H H H... TH TH TH TH TH TH..." The latter nonsense characters are written in a common geometrical design.
„ijāb al-„iŖn al-aŖīn
A second common amulet is the small booklet „ijāb al-„iŖn al-aŖīn by `Abdal`azīz ibn-„usayn, printed in Cairo, but to be found anywhere in Nigeria. It is mainly a collection of Qur'ānic texts justified by the verse, "In the Qur'ān we bring down healing and mercy for the believers" (17:82). The author promises that:the book will be useful for approaching kings and officials and for gaining love and acceptance. Whoever carries it and has difficulties will find that God lightens his burdens; anyone who is afraid will be safe; a sick person will become well; a debtor will find that God finishes his debt; a prisoner will find release from prison. This blessed amulet removes worry, sadness and distress by God's permission. If one says "Let something be", it will be. Anyone who reads it has equivalently read all inspired Scripture, and his reward will be great... Reciting it will quiet the crying of children, [drive away] the childbed demon, and if a woman's children do not live, they will live, by God's permission. It is useful for a pregnant woman, and when she gives birth she should hang it on the child and it will not come to any harm but will be under the protection of God, and it will protect him from the evil of men and jinns by the baraka of the Prophet. It is useful for ugly unmarried girls and for women. If they tie it to their hair with a green silk string they will quickly get married, by God's permission... If it is placed in a house or a shop, no thief will approach it and no Satan will enter it, nor will it burn. It is useful for dizziness and headache, and for the eyes. As for selling and buying, as soon as it is hung in a shop customers will become plenty and God will make it prosper...
There follows a section of "salvational" (munjiyāt) Qur'ānic quotations: 9:51, 6:17, 11:6, 11:56, 29:60, 35:2, 39:38. Then, on pages 14-15, comes the following prayer:O God, I ask you for a lasting faith, a submissive heart, useful, certain and true knowledge and firm religion. I ask you for lasting protection (najāt) from trials. I ask you for lasting health. I ask you for perfect health. I ask you for thankfulness for health. I ask you for freedom from depending on men rather than on the Lord of the universe. God bless Muammad...
Then there follows Sūrat al-adīd (57), the Verse of the Throne (2:255), and the 99 names of God (pp. 32-39). After this come some more Qur'ān selections, prefaced by the promise, "Anyone who recites this noble verse will not die on that day." The Qur'ān selections are: 9:128-129, 17:110-111, 18:107-110, 24:35, 30:17-19, the Sūra Yā Sīn (36 - a favorite amulet by itself), 113, and finally the Fāti³a (1).
Another very popular book for making amulets is Umm Mūsā, attributed to Ibn`Abbās, and printed in Kano by al-Hajj Tāsi` Yantando. It consists of 170 loose pages, which can be used separately or all together. The introduction offers the usual fabulous promises:Anyone who wears it or drinks it [the ink washed from a board] and prays with it against any creature, God will answer his request right away, whether it be for evil or good. And he will be protected against the evil of the Devil and of jinn and of men, by God's permission. For anyone who wears it God will open the gates of wealth, happiness, glory, honor and blessing, by God's permission. Anyone who wears it to keep away evil, poverty, pain, worry and distress will not see such, by God's permission. These are a few of the advantages of Umm Mūsā...: increase of wealth, honor and appreciation among people, whether men or women, young or old, free or slave.
The origin of the title (Mother of Moses) is not explained, except for a phrase following some cryptic words on page 134, "The daughter of Abū-Dardā' is the Mother of Moses, on him be peace"; this is followed by more cryptic words.
The body of the book consists of various Qur'ānic passages surrounding figures of animals or places mentioned in these passages or simply added. The figures are decorated with names of God, Muammad and his Companions or nonsense letters. Also interspersed within the Qur'ānic passages are magic squares, nonsense letters or cryptic words - which I might call babbling in tongues; a good example is Sūrat al-fīl (105) on page 156 - and invocations of God by mysterious non-Arabic names, such as Saqaku al`u YaŖu, or again „alada, Hanata, and invocations of strange angels such as Ya`a³afayā'il, `Alafayā`il (p. 25), `Ajabayā'il and his jinn (p. 71), Isrāfīl, `Azrā'īl, `A³fiyā'il (p. 76), `Alāyāyil (p. 79), as well as the familiar Mīkāyīl and Jibrīl (p. 76) and many others. Some of these names, as Fr. Anawati notes, are of Rabbinic Jewish origin, but others may be derived from letters corresponding to the numbers of Zodiac constellations. For these and the divine names, Anawati notes that in cabalistic and magical works there are many simply meaningless words, and its would be a futile exercise to apply one's ingenuity to discover a philological origin. (9) Sometimes it is not clear whether the names are those of God or of angels, especially if a seemingly angelic name is preceded by the invocation "Answer me". There are also lengthy repetitions of certain letters, for example four pages of "wa"s (pp. 26-29) and many other pages of other letters.
The book gives certain short prayers or Qur'ān passages which are to be recited a certain number of times, for example 7 times (p. 111), 77 times (p. 113), 66 times (p. 114), 777 times (p. 155) or even 1,111 times (p. 158). The prayer on page 155 (preceded by the invocation of strange angelic names): "O Opener [of the way to success], open for me a good success; O knower, give me guidance and knowledge" - is to be written on a black tablet and drunk. The person "will then find wealth in his selling and buying and much profit". There is a prayer for stomach-ache which is similarly to be written and drunk and a copy placed on a cloth over the stomach. A swift cure is assured (p. 127). Black magic at its worst comes out on pages 139-140:
Anyone who wants to destroy his enemy in the town should write this verse on a black paper four times and bury one in a refuse dump, another in shit and another in the sea. By God himself, your enemy will die quickly that very day.
The verse in question is Sūra 111, on the condemnation of Abū-Lahab, interspersed with invocations of strange angels and emphatic repetitions of curse words like "fire". There is another prayer for killing one's enemy on page 146. On page 159 there are two names, Jabbār and Mujabbir, which are to be worn if one wants to gain political authority. (10)
In every age there have been Muslims abreast with the latest scientific developments in medicine. Some old scientific approaches to medicine have survived to modern times in the form of traditional medicine. Along with scientific medicine there has existed religious medicine. It had its antecedents in the traditional beliefs of the Arabs and their neighbors, as well as in Judaism and Christianity. It developed in a particular way in Islam as an offshoot of Ąūfism, while in tropical Africa the magical aspect was brought to the fore in fierce competition with African traditional religious medicine.
1. On Islamic occasionalism, for a start, see W.M. Watt, The formative period of Islamic theology (Edinburgh, 1973), H.A. Wolfson, The philosophy of the Kalām (Harvard U.P., 1976), and G.C. Anawati, "La philosophie de la nature chez les penseurs musulmans au moyen āge", Atti del III Congresso Internazionale di Filosofia Medioevale (Milan, 1964).
2. See W.M. Watt, The majesty that was Islam (London, 1974), pp. 58 ff.).
3. Book 1, ch. 2; see also his Munqidh.
4. On the history of Islamic medicine see the somewhat idealized account of Seyyed Hossein Nasr, Islamic science, an illustrated study (London, 1976), ch. 8.
5. Al-munqidh min a²-²alāl, ch. 5.
6. See "Ąir" and "Hamā'il, Encyclopedia of Islam.
7. See G.C. Anawati, "Le nom suprême de Dieu", Atti del III Congresso di Studi Arabi e Islamici (Naples, 1967). This work contains an excellent 22 page bibliography on Muslim magic.
8. A useful study of these names is that of Robert Charles Stade, Ninety-nine names of God in Islam, a translation of the major portion of al-Ghazālī's al-MaqŖad al-asnā (Ibadan: Daystar, 1970).
9. Op. cit., p. 29.
10. For other interesting examples of charms for the general purposes of health and prosperity, see A.M. Honeyman, "A Muslim charm from West Africa", Glasgow U. Oriental Society Transactions, 13 (1947-49), pp. 53-56; Al-Hajj Thani Adamu Garanya Kano (no title or date); Ahmad ad-Drābī Mujarrabāt, with another Mujarrabāt attributed spuriously to M. b. Yūsuf as-Sanūsī (Cairo, 1969).