|Written by Dr. Shahid Athar|
The JIMA believes not only in the revivalism and finn establishment of the tenets of the Islamic faith within the individual and within Muslim society but also in restoration, review, research and compilation of the knowledge of the brilliant past of Islamic Medicine. We have proposed to several Islamic countries to open a department of Islamic Medicine in their medical schools as well as to establish an Institute of Islamic Medicine for gathering extent works of great Hakims of the past, to translate them, to do clinical and laboratory research on their empirical findings and their vast Pharmacopoeia.
Who was Ruhawi?
Ishaq Ibn Ali Al-Ruhawi must have written his deontological treatise, Adab al-Tabib in the 9th century. After al-Rubawi, to complete the picture, one should mention two of the greatest physician-philosophers of the Islamic World, al-Farabi (d. 950 A.D.) AND IBN SINA (B. 980 A.D.). Al- Ruhawi was probably from Ruha, a city of northwest Iraq. Earlier, it had been called Edessa, a well known center of Nestorian learning at one time. He was a Christian who embraced Islam and had written two works on Galen.
Statement on Edible Matter
(Ruhawi's Adab al-Tabib translated by Martin Levey)
Since what we have mentioned in regard to the five senses is useful for systematic improvement, a word is in order on the natural matters as an example and for guidance,. We mentioned the natural matters of air, exercise, and rest. It is necessary to follow up with a statement on edible matter, by the way, with brevity and with mention of useful factors which will encourage and urge one to study science in its occurrences and its books.
I say that edible matter may be called food as a synonym since food is sometimes made of it. Real foods are substances which are distinguished from edible matter by the first, second, and third cooking, and their superfluities, which are not eaten, are thrown away. Those substances remain which are suited to become a part of the one who eats [them], and takes the place of what was lost by him since they make a quantitative excess. In this way, he is not dissolved away and does not perish.
The situation is such that you will find that edible things have different tastes and qualities, and accordingly affect the body in various ways. Thus, it is necessary to know their composition and functions. I mean also that one should also understand the body and its natural complexion; together with this it is indispensable for you to know the natural or acquired complexion of its stomach.
Our excellent teacher Galen encourages and leads us to this in his book On Nutrition. He said, "It is necessary that one be careful to know these matters. You find that foods sometimes are slow to swell up and sometimes quick. This depends on the reaction of the stomach at the beginning or by the substances in that which was eaten and drunk. Because some of them are moist, some dry, some viscous, some quickly separating and falling apart, some pungent and acrid, some sour or bitter or sweet or salty, and sometimes these properties are found in drugs, therefore properties of foods are considered as easy remedies."' It is essential that the physician take Galen completely at his word to the full extent of this science for the preservation of life is of great importance.
Galen said that the science of the properties of foods is close to being one of the most useful of medical sciences. While there is not always need to employ the other [sciences] for bodily health, the need for food is always present, both in times of health and illness, for life does not go on without it.
It is not necessary, 0 physician, that you imitate any writer in regard to the properties of foods, their states, and their functions in the body. Some have written volumes on the basis of experience but this experience is insufficient when applied to an actual case. You may, however, find some similar factors which are common but it is not sound to judge by these merely. An example of this is that you find several things which cause diuresis or facilitate an abundant flow, and so on. You find that some are cold and some hot. In teaching this, Galen quoted the scholar and physician before him called Theophilus. It is this, Galen said that Theophilus stated that men are not wise who believe that a single property like taste or heat or smell when found in two things will make them all alike. Aside from this common factor, there may be many different properties. One must not, therefore, treat all substances which empty the belly, or cause diuresis, or have any other common property, as being alike in all their properties. This is so because that (substance] may be hot or cold or salty and not every sweet or salty thing has the same strength in taste. But one may consider that the resultant action of a substance comes from its total make-up. Whoever grasps this principle will make no mistake and will not lose the truth.
It is not convenient for you to hold back anything of a food or drug because of its effect on one sense, and so believing that it possesses only this effect. Sometimes you find that what seems very apparent is one thing but its actual effect is another. Examples are the lentil and cabbage which act oppositely [to their effect on the sense of smell]. They empty some bellies and fill others; they do this since in their creation they are made up of two different substances having two different properties in composition and complexion.
Galen said, "As to the reason why the lentil' empties and softens the belly of some people, and does not restrict and block it, I add that I explained this in the book On Simple Drugs. It is that many kinds [of drugs] which are considered to be simple and single are compounded, at the beginning of their creation, of different substances with opposite properties instead of what we compound with our skill. In them, there are different activities. You find these in many foods like the lentil, cabbage, and all sea animals which have a skin with a sharp taste; each one of them is composed [of substances] with opposite properties. Thus, their body is hard and slow to swell, the belly is under control and may be emptied. The explanation for this is what when they are cooked, their soup empties the belly but its hard body keeps the belly under control. People, however, disagree about this.
When considering foods, the conditions in the stomach [should be recognized]. You may find that a flame heat dominates it. This may be so because of the complexion brought about in creation or yellow bile which pours into it because it has been deviated from its source on its way to the intestines. In this case the stomach digests some foods which are thick like beef, etc., and the thin ones like the meat of chicken and partridge spoil in it. It is not necessary to examine and experiment with the foods to prohibit some since some are quickly land some are slowly digested, according to the conditions in the stomach. Since this stomach condition is far from normal, it is not correct to make a judgment on the foods in it.
It is necessary to examine once more the question of foods. Some edibles which are in abundance resemble body matter. These are wheat, barley, rice, and similar grains; also there are palatable foods as animal meats which may be quickly cooked and digested. All of these and what is similar to them feed man when they are well prepared; they are good nutritionally.
As to the edibles which do not resemble the body of the eater, when they are together with non-nutritional matter [they] may make one ill if he does not know how to use them. These edibles have excessive sourness, are excessively salty, excessively sweet, and an excessively styptic acridity may predominate. These are more like drugs. Between the extremes of these edibles and their opposites, there are many which, when well prepared, will nourish the eater and not injure him.
There are also those which, because of moderation in taste, are often employed to improve bodies. It improves the health of old people, especially those whose complexion is cold, in whom phlegm predominates, in periods of cold and in cold countries. Understand this, and compare with it the rest of the edibles which have obvious and different tastes. When you recognize good food, then beware of an excess or deficiency but favor moderation. This is better.
Hippocrates had a saying that every excess is an enemy of nature, and a deficiency is lacking in trustworthiness. When one exceeds the natural amount, Hippocrates stated that there is no bearing or appetite or any other favorable thing. Hippocrates also said that when excessive food is ingested, it is superfluous and causes illness with its coldness.' He stated that it is important that one predetermine the amount of food for the body with regard to the state of the season in which one is. There are two seasons, summer and autumn, when the body cannot endure excessive food. In regard to the seasons of winter and spring, it may take much food. Hippocrates pointed this out in a statement when he declared that the most difficult period for the body to take care of food is in summer and autumn; the easiest time is in winter and spring. Galen explained and commented upon this by saying that bodies begin to be cold in the autumn, to come together to be thick, and then in winter to loosen and to be light. Galen said also that in winter and spring, the belly is hottest and sleep is longer, Because of these two reasons, more food is necessary since more natural bodily heat is required then. Thus, more food is essential. Evidence of this comes from the aged.
It is also indispensable to know the time of the meal and the small snacks. I mean that it is necessary to eat during the day and night, and [it is necessary] to know the time between meals. The eater must know this and also the speed of his digestion, and also how long it takes his stomach to be emptied of the last meal and of spoiled mixtures and excesses. Hippocrates summed this up when he stated in On Epidemics, in the sixth discourse, when he arranged for the food after exercise and before sleep. He said, "Weariness, food, sleep, and coition must be aU organized by a natural arrangement." He meant that one must predetermine intentionally the quantity of exertion of each one by the eater. Hippocrates said that the body which is not clean, whenever it ingests food, makes its advances in evil
In some edibles like vegetables, there is very little nutriment; in some there is much as in animal meats and hard grains. Some are in between these like the meat of lamb, chicken, partridge, the yolk of eggs, etc. For this reason, it is necessary to know the science of this to use what is valuable according to the need. [Another reason] is that the spoilation of some edibles is rapid since they change so quickly; some are slow to spoil since they are resistant.
Thus, it is incumbent upon the physician to know the arrangements of food according to this and according to the condition of the stomach. It is often convenient to present the quickly changing foods first before those which ripen slowly in order to facilitate the penetration of a hard one so that it not be spoiled were it to precede the quick one. To eat melon, apricot, and others first before bread and other edibles is better. For this reason, one must be careful what he cats after the meal so as not to spoil the food, mixtures, and the stomach. Do not neglect, in view of what i have presented, to take account of age, heat, the countries, habits, occupations, and conditions since the science of an these is necessarily indispensable for everyone who wishes to nourish his body properly. Carry on by these and compare them.
Statement on Beverages
As to the water which is contrary to that here mentioned, its matter has mixed with other matter possessing other attributes like sulphur and borax waters, etc. Waters like these have different tastes and properties. Owing to the fact that they vary in taste, smell and weight, for this reason, they affect the body in different ways. The physician must know the properties of waters and their differences. Otherwise, if the question of water is neglected, great harm will come to the body; this is because it is essential for life and its need is continuous.
So far as internal harm to the body is concerned, then, there are the matter [of water], the matter of the air, the factor of the seasons when they change, and the effect of the winds generally in [some] countries. Therefore, Hippocrates said that he, who wants to study medicine the straightforward way, must do this that I describe. It is, first, that you must consider the times of the year and what can be done since they are not alike. They are very different not only in themselves but compared also to others. Then, attention must be paid to the hot and cold winds, especially those common to all people and those peculiar to each country. It is also necessary to consider the properties of waters since they may not only differ in taste and weight but also be different in [other] properties.
When we reflect on the results of Hippocrates' advice, we understand that water is important, when suitable, for the preservation of health; it is harmful if not suitable. No one can be more discriminating in acquiring this [knowledge] than were the ancients. The most efficient in this was Hippocrates so listen to his teaching and hold on to it in order to attain your wish in the art of medicine.
Hippocrates said, "I want to inform you of the other waters and which of them are more effective in bringing good health. I shall describe what it is necessary to derive from evil and salty waters since the kind of waters is very important in aiding health.
There are waters which are stagnant, tainted and are at the bottom. These are warm, odorous, and thick in summer for they do not flow. They are used since rainwater does reach them. They tend toward a dirty color and are bitter. In winter, they are covered with ice, and are turbid with the water coming from snow and hail. These waters are the most apt to cause phlegm, hoarseness, and a large, hard spleen in the one who always drinks them.
He said that these waters are bad for all things. Further, those waters which issue forth from rocky places are harsh like those which come from earth where there are hot waters, or where copper, silver, gold, sulphur, alum, or borax are produced. It is because these are produced form a hot shaft and it is impossible that good waters come from this earth. They are harsh, cause difficulty in urination, and prevent excretion.
He said that the best waters flow from lofty and high places, from mountains which have soil. These waters, whose sources are deeper, are palatable, pure, have little redness, are hot in winter and cold in summer. Superior waters, he said, are those whose sources are opposite to the rising locations of the sun; those after them (in superiority] have their sources between where the summer sun rises and sets. The third best are the waters [whose source is] between where the winter sun sets and where the summer sun sets. The worst waters arise opposite to the north. The waters are very bad in the times of the southern winds but; better in the times of the northern winds. He said that it is necessary to use these waters knowing this. As to the healthy and strong person, it is not essential that the discriminate among the waters; he drinks what is available. He praised rainwater as the lightest purest, most palatable, and finest of waters. This is because when the sun raises the water, it carries off the thinnest and lightest. Consider the use of the saltpan where the salty part of the water remains because of its thickness and heaviness, becoming saltier. The sun carries off the finer water; since it is light it raises it. It is raised from palatable waters, from sea water, from all bodies, and from the bodies of men continuously [especially] that which is the thinnest and lightest of the moisture.
Thus, when a man walks or sits in the sun and puts on his clothes then that part of his body exposed to the sun does not seem to perspire since the sun always carries away the perspiration by evaporating it. That part of his body which is covered with clothes or anything else perspires because the sun causes the sweat to come out. The covering keeps and preserve it. When this man moves into the shade, all his body is so since the rays of the sun do not fall upon him. For this reason, rainwater may be putrid and have a bad odor since it comes from many different kinds of moisture and is mixed with them. As a result, it is the first of waters to stink.
Then, after Hippocrates demonstrated how rainwater comes about, he said, "This water may be the best of waters but it needs to be cleansed by boiling." Then he said, "If this is not done, then it develops a bad odor and it causes the drinker to be hoarse, to cough, and to have trouble with the voice." Then said Hippocrates, "As to the water from snow and ice, it is all bad since when water is once frozen, it will not get back to its original properties but that which is pure, light, and palatable is expressed. The sediment and what is close to being a solid remains."
I have mentioned these quotations from Hippocrates to show the pressing need of water and to encourage you to study this science in the books of Hippocrates and Galen.
I shall now return to the value of taking hot water baths. The value of this bathing is different for the sick and for those who are well. For healthy people, it is good to bathe in potable, cold water, or for some in water with salt or borax, and for some with other tastes, hot and non-hot water. These waters may be good for some sick people but not for all, for people of certain ages but not for all, in some but not all countries, and depending on certain habits.
In this, there may be much error; it is necessary to be aware of it and to study it. Strive to know the good from the bad waters by the method described by Hippocrates. These methods are these. Make your decision according to the lightness of the water. its ability to become quickly cold or hot. Hippocrates said about this, "The water which warms quickly and becomes cold quickly is the lightest of waters." In the fifth section of his book, he said, "The lightness of its weight is so in comparison with any other, and is seen in the rapidity of its drying with what was kneaded with it, and in the quickness of cooking what is cooked [in it]."
Statement on Sleeping and Being Awake
The physician takes care of the matter of sleeping and waking and knows the function of each in healthy and sick bodies. Thus, he should be able, according to bodies of animals, to predetermine the state of a sufficient and suitable amount [of sleep] for the preservation of health and treatment of the ill. This is because sleep is a natural thing without which man cannot retain his health; there must be a definite time for it in the natural order.
Statement on Psychic Events
It is necessary fox the physician also to know what psychic events are, how many there are, and from where each kind stems. If he does not know these, then he cannot preserve them in their natural condition and drive away the non-natural. It is said that you should know that man has a power by which he distinguishes and thinks, a power by which he is angry and enraged, and thirdly, a power by which he desires and lusts for pleasures. Man completes his actions and work by these three powers. The ancients called them the deteriorating powers; they recognized that characters and physical events are different for each of these three kinds of power of the soul.
Statement on Habits
Hippocrates said much concerning this. I shall give two of them [i.e. his statements]. One concerns the change of habits of people. The second is general, and example of which is the case of different people who are accustomed to certain things which are very natural for them. It is not good to give these up.
As to the statement of Hippocrates in regard to the habits of people, he said, "It is obvious that unwise management in eating and drinking is harmful for the preservation of health. This is easily seen in the change from one kind of regimen to another. The change in one who was accustomed to eating once [a day] to a contrary [system] causes harm and weakness. If one eats at an unaccustomed time, it weakens him immediately, overburdens his body, and makes it lazy and atonic.
"Some may be exposed to the softness of nature. The cause of this is that one's stomach is exposed to the contrary of what is the natural state. This may be because his habit was to have an empty stomach and not be filled twice, and not to digest food twice. It may become accustomed to being filled twice, i.e. in the transition period from one habit of eating to another, if the bowels had been exhausted in the [double) eating period. For this, it is required that one sleep the entire night after the evening meal, if it is winter avoiding the cold, and if it is summer avoiding the heat. If it is not possible for one to sleep then he walks gently a great deal without stopping. After that he does not eat or eats only a little. A little does not harm one; having the same effect is also a drink not mixed with water."
This statement of Hippocrates is sufficient to explain and serve as an example for what we mentioned of the change in the body with the change in habits for anyone. If you wish to listen to all that Hippocrates has related on the subject of habits and also what Galen has said in his commentary on it, then delve into Hippocrates' book and Galen's commentary on it.
As to a general example, Hippocrates said, "I shall give you a demonstration from the best of proofs as to the softness of one's body. This is that you find many Scythians, all of whom are in agriculture, who are heavy in their shoulder blades, in their upper arms, wrists, haunches, and in their chests. This is due only to the softness of their nature. They cannot string a bow or shoot javelins with their shoulders because of their softness and weakness. If they are steamed, the moistness in their joints dries and they become stronger than previously...
"They are not bound in clothes in childhood as is practiced in Egypt. This is not their usual custom since they ride the horse constantly. Those males who cannot ride the horse but sit on the cart rarely hasten in walking because of their heaviness; their females are stronger than they in breadth and thickness."
He also said, "I declare that because they ride the horse, they are affected by an illness called qadmata in Greek . This is because their feet are always suspended on the horse. When the illness is strongly evident, they become lame. They treat themselves in this manner. When their illness begins, they cut open two veins behind the ears bilaterally. When the blood is shed, sleep overpowers them because of weakness. So they complete the treatment; some of them recover and some do not."
I believe that the seminal fluid is corrupted by this treatment since whoever is bled in these two veins behind the ears becomes sterile. Most are bled only in those two veins.
Thus, I have related to you these statements once again and improved the way for you to recognize the changes due to habit in healthy and ill people. If you wish to listen to the words of Hippocrates on habits, and how the inhabitants of [various] countries acquire them depending on the change of air, water, and countries, read what he wrote in his book on countries, water, and air. By means of it, you will be in a position to judge many factors related to habits. I finish [here) what I mentioned to you [hoping to] awaken and encourage [you].