The Islamic Medicine Research Program (IMRP):

Reflections and Proposals

…natural medicines made out of herbs and plants will always be the bestand slowly, very slowly, Europeans and Western societies are coming back

to the wisdom of using natural medicines.1

1. Introduction

Islamic Medicine, at core, is like what can be called an Integrative Medical Conceptual Framework (IMCF), or an Integrative Medical Principle (IMP), allowing it to systemically identify, appropriate and incorporate into its own medical theory, therapeutic framework and clinical practice, what is proven to be experientially and empirically good in all medical systems, modern or ancient, without compromising its own vision of what it means to be human and to be healthy. An important objective of this Colloquium is to flesh out this conceptualization in further detail in a way that people in the medical profession can find to be conceptually and empirically generative and fruitful, for our re-engagement with our own 1,500 year medical tradition has to be programmatic toward making it a living civilizational reality again. This means we are not all interested in Islamic Medicine as a cultural curiousity out of a vague sense of nostalgia for a past grandeur. Rather we are interested in Islamic Medicine as, to paraphrase Fulder, “one of the most sophisticated medical systems known to man. The Islamic methods of treating the healthy to prevent sickness and of treating the sick to reestablish their health, and its extraordinary skill in the use of subtle therapeutic techniques are so precisely those needed by us at this time that

1 Shaykh Nazim al-Haqqani al-Naqshabandi, Natural Medicines (London: TaHa, 1992), page facing inside front cover.

they must gradually alter the way we understand and practice medicine today.”2

The Islamic Medicine Research Program (IMRP) envisioned along these lines will lead to a revival of Islamic Medicine in the present context that can provide a conceptually rich and yet practical medical alternative to modern, western medicine; in effect a parallel medical paradigm or counter medical system that engages and interacts closely with the modern system and yet remain autonomous and self-sustaining, with a great potential to critically and proactively identify, appropriate and integrate positive aspects of the modern system into its own holistic vision and practice of preserving health and overall well-being, rather than focusing on “fighting” any particular disease symptom or pathologic agent per se.

Research into Islamic Medicine is not only medical, empirical or clinical, but also philosophical, historical and cross-cultural (e.g., as in ethnomedicine and comparative medicine), for there is so much of time-tested traditional medical methods, therapies, remedies and ideas that have been lost to our collective intellectual and cultural memory due to systemic, reductionistic medical westernization, and hence, for the Islamic Medicine Research Program (IMRP) to move forward, historical and cross-cultural research is also important. This does not mean that all doctors and medical academics and professionals have to do the actual arduous textual and field research, but that all of them should be aware of such research as has been, is being and shall be done, know how to access it and render it accessible to other practitioners and to their students and patients, and to the lay public in general. But at the very least, all medical colleges, faculties or departments dedicated to the revival and enhancement of Islamic Medicine must each have a center or unit devoted to research in the philosophical, historical, indigenous and cross-cultural aspects of medicine, or at the very, very least in order to save costs and conserve intellectual and academic resources, a number of independent colleges can network together as partners to contribute to the setting up of a common research center, which in turn can be linked to similar research centers and networks in other countries.

Islamic Medicine is basically Natural or Fitrah Medicine (al-Tibb al-Fitri) which is centred on a sophisticated philosophical, spiritual and empirical psychology of the self-body dual nature of the human being, in which the physical body is seen as serving the spiritual (or true) self, while critically drawing its medical content from the ancient medical traditions of diverse

2 Stephen Fulder, The Tao of Medicine (Rochester, Vermont: Destiny Books, 1987). He was referring to traditional Chinese medicine, but the import of his words are equally applicable to Islamic Medicine.

cultures, Greek, Egyptian, Indian, Persian, Arabian and Chinese, as well as adding on these accumulated medical wisdom from the medical traditions of the Prophet himself (al-Tibb al-Nabawi), sallallahu ‘alayhi wasallam, all within an overarching integrative conceptual framework, which is the Worldview of Islam (ru’yat al-Islam lil-wujud). As Dr. Rehan Zaidi of Sunnipath Academy puts it:

One commonality between the Eastern medical traditions and Prophetic medicine is their concept of holism, a view documented well over 1,000 years ago explaining the value of the mind-body-spirit connection—discussions modern science seriously begun to explore only in the past 20 years. There are also many other similarities the Prophet's medicine has with the Eastern medical systems, such as Chinese Medicine. Both these systems place emphasis on procedures such as cupping, herbal therapy, and dietary modification, with fundamental reliance on prevention, balance, and non-physical forces such as energy and prayer.3

This colloquium (or “speaking together”=muhadathah, mukalamah) draws on this time-tested, cosmopolitan heritage and invites the relevant parties to revive it in the context of a contemporary conceptual, rational and empirical Islamic Medicine Research Program (IMRP), one major component of which is a systemic evidence-based reinvestigation of the clinical practices, remedies and therapies documented in the classical Islamic medical texts, including Tibb Nabawi texts, and another of which is a systemic critical survey of contemporary medical approaches from East & West, including indigenous ethnomedical textual and oral traditions which are found to be in accord for the most part with Islamic medical philosophy and axiology, such as naturopathy, homeopathy, kampo, ayurveda, acupuncture, chiqong, food/dietary/nutritional therapy, sleep therapy, traditional Malay and Malay-Islamc remedies and therapies, including even aspects of modern western secular allopathic and technological approaches that can be critically integrated into the Islamic Medicine conceptual and operational framework.

3 Personal correspondence, February 2010.

2. Why must we go back to tradition?

Verily in their (hi)stories is a lesson for people who reflect.4

What has been said in the introduction above assumes that there is a big, systemic problem in modern medicine, for if everything is all right for the most part with the mainstream system, there shouldn’t be any need to look for alternatives, much less to develop or re-develop counter-systems called by various names, natural medicine, complimentary medicine, traditional medicine, alternative medicine, indigenous medicine and the like---why go back to the past when the present is so good already and the future even better? The answer is simply that modern western medical bandwagon is in a very bad shape, and the sooner we get of it the better it will be for our physical and spiritual health. Moreover, this answer finds insider support from Dr. Mahler, a former Director General of the World Health organization:

Most of the world’s medical schools prepare doctors, not to take care of the health of the people, but instead of a medical practice that is blind to anything but disease and the technology for dealing with it; a technology involving astronomical and ever-increasing prices directed towards fewer and fewer people who are often selected not so much by social class or wealth as by medical technology itself, and frequently focused on persons in the final stages of life….The medical empire and its closely related aggressive industry of diagnostic and therapeutic weapons sometimes appear more of a threat than a

4 Surah Yusuf.

contribution to health….the very attempt to diagnose and treat one ill may produce another, be it through side effects or iatrogenesis….5

Hence another major component of the Islamic Medicine Research Program (IMRP) is to demonstrate that there is indeed an examined basis to the assumption of serious shortcomings in the mainstream modern western allopathic medical system. At the very least such a demonstration will render modern medical education less dogmatic and more self-critical and produces doctors who are also wise thinkers rather than mere technicians beholden more to the financial health of the pharmaceutical corporations than to the medical health of their patients. At the most, we can all begin to realize that (i) there can be more than one way to tackle any particular medical challenge, (ii) that medicine as a successful theoretical and empirical science is something that predates the modern allopathic system by at least 5,000 years, that (iii) modern western civilization does not have a monopoly on medical techniques and wisdom, that (iv) older civilizations can still have much to offer in terms of experientially grounded medical practice and sound medical philosophies and theories, and hence that (v) therapeutic diversity is possible, desirable and realizable.

In short, this systemic rethinking of the modern allopathic paradigm will consist of basically (i) a negative critique that exposes its mortal shortcomings, and (ii) a positive critique that offers a counter paradigm or paradigms capable of generating alternative and better therapeutic approaches that are capable of overcome each of those shortcomings as well as enhancing overall wellbeing.

3. Natural Medicine in the Light of Some Current Rethinkings in Modern Medicine6

Just as modern western secular agriculture grows toxic foodstuffs by poisoning the earth, so similarly we find modern western medicine manufacturing (fabricating, concocting) dangerous synthetic drugs derived through the drug “research” method of torturing animals (e.g., vivisection) in

5 Cited in Fulder, Tao of Medicine, 33.6 For an Islamic, Sufi point of view and some practical remedies, see Shaykh Nazim al-Haqqani, Natural Medicines (London: TaHa, 1992).

order to poison the human body (e.g., chemotherapy) and still these chemically synthesized drugs are called medicine!7

Vivisection (the very term means “to cut alive”) is the way modern, business-driven medicine tortures live animals to test drugs in order to cure humanity of their ever lengthening list of old and new diseases.8 As a method of medical research it is relatively new (a hundred or so years’ old) and peculiar to modern western medical culture. Quite apart from the extrinsic question of ethics in respect thereof, there is also a more fundamental intrinsic question, namely the question of the scientific integrity (or cognitive value) of the underlying, largely unexamined assumption of a significant degree of biological and physiological similarity between laboratory test animals and human beings justifying extrapolations of clinical results from one to the other. The IMRP for Muslim medical researchers in this regard will be to find systemic alternatives of unquestioned scientific and ethical integrity to vivisection, including valid alternatives critically sourced from presently marginalized western and eastern sources which could be incorporated into the IMRP. Some of these alternatives can be gleaned by relooking into the well documented but largely neglected vast medical corpus of the very successful one thousand years’ old Islamic cosmopolitan medical tradition.9

In many ways, the modern age is the age of Violent Agriculture10 and Violent Medicine. In many ways Modernity is Violenity. As a matter of fact, the dangerous drugs industry is closely intertwined with the toxic chemical industry. Take the infamous drug thalidomide for instance which was chemically synthesized and then tested on life mice (and systematically torturing them in the process of course), and then pronounced safe for

7 For some critiques, see Pietro Croce, Vivisection or Science: An Investigation into Testing Drugs and Safeguarding Health (London: Zed Books); Ray Greek, Golden Goose and Sacred Cows; Stephen Fulder, The Tao of Medicine: Oriental Remedies and the Pharmocology of Harmony (Rochester, Vermont: Destiny Books, 1987). 8 Pietro Croce, Vivisection or Science: An Investigation into Testing Drugs and Safeguarding Health (London: Zed Books, 1999), reviewed by Adi Setia in Islam & Science, vol. 3 no. 1 (Summer 2005), 87—90; cf. Moneim A. Fadali, Animal Experimentation: A Harvest of Shame (Los Angeles: Hidden Springs Press, 1997), and Ray Greek, Sacred Cows and Golden Geese: The Human Cost of Experimenting on Animals (London: Continuum International, 2000). An informative, eye-opening monograph on the the proper treatment of animals according to the traditional Islamic sources is, Al-Hafiz B. A. Masri, Animals in Islam (Petersfield, Hants:Athene Trust, 1989). 9 A good starting for delving into the operative context of the Islamic medical tradition is Fazlur Rahman, Health and Medicine in the Islamic Tradition: Change and Identity (Chicago: Kazi Publications, 1998); cf. Franz Rosenthal, Science and Medicine in Islam: A Collection of Essays (Aldershot: Variorum, 1991).10 Vandana Shiva, Violence of the Green Revolution; Manu L. Kothari and Lopa A. Metha, “Violence in Modern Medicine,” in Ashis Nandy, ed., Science, Hegemony and Violence: A Requiem for Modernity (Delhi: Oxford U. Press, 1990), 167—210.

human consumption as sleeping pill for pregnant women which then resulted in very many THOUSANDS of foetal deformities. Despite this well-documented fact of systemic medico-commercial negligence, incompetence and irresponsibility, the same basic method of drug research, regulation and marketing continues to be perpetuated, resulting in the present problematic case of, say, the drug Vioxx.11 Even aspirin, arguably the most common over-the-counter drug has its own very problematic problems. For Muslim doctors and medical researchers who care about the Islamic Medicine and Islamization of Medicine, it should be pertinent here for them to note that the great Ibn Sina a thousand years ago has already proscribed the practice of experimenting drugs meant for humans on animals. He says, “The experimentation must be done with the human body, for testing a drug on a lion or a horse might not prove anything about its effect on man.”12 Both the scientific and ethical crisis of modern medicine is well captured by Dr. Stephen Fulder when he notes that:

The drugs we now use have been found to be generally harmful and in many cases of questionable benefit. They are tens of thousands of different drugs on the market now, such a confusing plethora that the World Health Organization recently prepared a model list of essential drugs for Third World countries, and found that only 2 per cent of the total of drugs sold were really necessary….A recent Wall Street survey showed that less than 1 per cent of the drugs which were currently on trial promised important therapeutic gains….The doctors seem befuddled by ever more pressure. ‘Doctors are pushed around and bullied and bribed by the drug industry. They have undoubtedly lost control of their own profession and must consequently be held responsible for all the disasters and errors which bad prescribing produces.13

The big question, in my view, in regard to all these medical problematics, is this:

11 Vioxx.12 See the detailed Wikipedia article on him (“Avicenna”) with detailed documentation. 13 Fulder, Tao of Medicine, 35—36.

If a medicinal remedy or drug is taken according to the doctor’s instructions and yet causes debilitating even life threatening side-effects, then can it truly be of real therapeutic value? Can it even be called medicine when the process of attacking the disease, illness or pathogenic agent results in the eventual destruction of the very body of the patient whose health that medicine was supposed to safeguard in the first place?14

To quote Dr. Fulder again:

The extent to which the health of man is compromised by drugs is never fully appreciated. The care of patients suffering from the harmful effects of drugs is now put at around 3000 million dollars annually in the United States alone. One study calculated that some 15 per cent of old people are admitted to hospital as a direct result of the consumption of drugs. We hear of the most dramatic cases such as thalidomide, the sleeping pill which caused foetal deformities….Depression, for example, is a form of drug side-effect produced by almost every kind of drug known….Salicylic acid was one of the first pure chemicals to be isolated and taken medicinally. Now acetyl salicylic acid, or aspirin, is the most widely used drug in the world. Fifteen thousand million tablets were consumed in 1976 in the United States. Yet evidence is only now emerging of gastric damage and possible infertility as a result of aspirin use. Pregnant women taking aspirin may have smaller babies, more complications and stillbirths, and their babies’ health may be affected. In many cases, drug side-effects only appear after years of use

14 My formulation of the issue.

and what was once an ultra-safe drugs turn into a gradually damaging one.15

Mind you, Dr. Fulder was writing this over almost 30 years ago but anyone who follows the issue will know that the situation has only become worse. But then one might say that Dr. Fulder is writing from the perspective of one already somewhat disillusioned with modern western medicine and biased toward what he calls “the pharmacology of harmony” he found in traditional Chinese medicine. However, such an evaluation cannot be applied to the case of Dr. Eugene D. Robin, a thoroughly mainstream physician and medical scientist, who penned an “eye-opening” critical analysis of the mainstream medical system and deplored its tendency toward “making patients out of normal human beings.” His appendix on “Recommendations for Changing the Medical Systems” is still worth studying, though while he advocated reform from within the mainstream medical box, we would say that the real reform and solution lies in reviving and enhancing the natural medicine box in order to work within it and thereby allowing us to escape from the intellectual and cultural pathology of a “medicine in a Cul-de-sac.”16

As a result of these and other acute problems with modern medicine (e.g., prohibitive expense due to over commercialization and a research culture pulled by the short term profit factor rather than long term public interest, etc.), there is a robustly growing movement in both the West and the East back to various forms of traditional and contemporary natural medical and pharmachological system such as herbalism,17 homeopathy, naturopathy, ayurveda, acupuncture, chiqong, Islamic Unani medicine (Avicennan medicine),18 traditional Malay-Islamic medicine,19 indigenous Orang Asli medicine, Japanese kampo medicine, and so on and so forth, many of which can be systematically and critically integrated into a contemporary revival of Islamic Medicine, based on a critical evidence-based 15 Fulder, Tao of Medicine, 36—37. For more on the serious side-effects of modern chemosynthetic drugs, see 16 Fulder, Tao of Medicine, 30—52.17 Eg., Ross Trattler, Better Health through Natural Healing: How to Get Well without Drugs or Surgery (Hinkler, 2001); 18 Mohd. Hilmi b. Abdullah, Teori-Teori Asas Perubatan Ibnu Sina (Kota Baru: Pustaka Hilmi, 2005); idem, Rawatan Umum dalam Perubatan Ibnu Sina (Kota Baru: Pustaka Hilmi, 2007); 19 Roland Werner, Royal Healer: The Legacy of Nik Abdul Rahman bin Hj. Nik Dir of Kelantan (Kuala Lumpur: University of Malaya Press, 2002); idem, Medicines in Malay Villages (Kuala Lumpur: University of Malaya Press, 2002); Musa Nordin, The Forgotten Jungle Medicine of Taman Negara Pahang (Penang: Malaysian Phamarceutical Society, 2007); Anisah Barakbah, Ensiklopedia Perbidanan Melayu (Kuala Lumpur: Utusan, 2007); Harun Mat Piah, Kitab Tib, Ilmu Perubatan Melayu (Kuala Lumpur: Perpustakaan Negara Malaysia, 2006); Ab. Razak Ab. Karim, Analisis Bahasa dalam Kitab Tib Potianak (Kuala Lumpur: DBP, 2006); Noraida Arifin, Penyembuhan Semula Jadi dengan Herba (Kuala Lumpur: PTS, 2007).

(rather than profit-based) research framework. This would be a central aspect of Islamization of Medicine in practice, and to achieve this we need to formulate in detail a comprehensive IMRP (Islamic Medicine Research Program) and to found medical research institutes, centres, universities and colleges to implement it in the general, long term public interest and not narrow short term commercial interest.

4. Toward a Market Welfare Economic and Business Model for Natural Medicine

The underlying ethos of natural medicine is one of public service rather than private profit, and hence thinkers and practitioners of natural medicine will also have to consider an alternative business or economic model (other than the current neoliberal capitalist model) for reviving, enhancing and sustaining it over the long term. The focus is more on individual and social wellbeing rather than strictly financial or monetary returns to a private “health” corporation bottom line. The alternative economic model I propose here is what can be called the Islamic gift economy (iqtisad infaqi) model or Islamic market welfare model, which in the history of Islamic Civilization was systemically realized in the august institution of waqf (private charitable endowments in the public interest). Perhaps on another occasion we may have an opportunity to flesh out in some detail the application of the gift economy model or market welfare model for financing natural medicine education, research and practice in the public interest.