[Illustration: Teaching Caesarean Birth, al-Biruni, (973-1051 CE)


The Arabic books on the Prophet’s Medicine generally begin with an overview of the human constitution. Since this is far different than would be found in medical school today, it is important to understand the context in which statements about human health were made centuries ago. In describing man, seven parts of his “natural” being were distinguished. At the most fundamental level the human body was seen as a mixture of the four basic elements that defined the material world in classical science. These were fire (hot and dry), air (hot and wet), water (cold and wet) and earth (cold and dry). In this physical respect the human body was no different from other animals. And these were the same elements that were thought to make up everything material in the universe.

The second relevant part of man was his temperament, a broad-ranging category including emotions, feelings, and character. Nine types of temperament were identified, but the first and foremost was one that was evenly balanced. Man was considered to be the most evenly balanced animal in temperament. For the Muslim, the most balanced man who ever lived was Muhammad, God’s messenger, whose character was said to be in total harmony with his physical nature. The companions of Muhammad noted that he was the most handsome and had the best character of anyone. One of his followers, Anas, reported that in ten years of serving Muhammad, he was never once upbraided nor criticized. Another claimed that Muhammad never used indecent language or behaved improperly. Even when a Bedouin once roughly pulled a cloak off the prophet’s shoulder, he laughed rather than getting angry. It is reported in one of the traditions that a man asked Muhammad for some advice and the advice given was never to get angry. Anger, Muhammad said, was from the Devil and therefore should be avoided. For pious Muslims of later centuries the qualities attributed to Muhammad were seen as defining the perfect man.

Related to the basic elements were the four humors, which comprised the physical makeup of the body. This humoral system, widely established in the classical tradition, went largely unchallenged in both the Muslim East and Christian West up until the Renaissance. Anyone listening to a Shakespearian play is familiar with the idea of the bodily humors, part of the popular conception of health in Elizabethan England. Blood, considered to be hot and wet, was said to be the best because it feeds the body. The medieval scholar believed blood was produced in the liver from the remains of digested food. Phlegm, cold and wet, helps convert blood into sustenance for the body, and keeps the organs and various parts of the body moist. The gall bladder stored the body’s supply of yellow bile, viewed as hot and dry. This bile was thought to help the blood through narrow vessels and was responsible for the color of feces. Black bile, produced in the spleen and considered cold and dry, thickened the blood and assisted in bone growth. By coming into the stomach it also helped create the appetite for food. Despite the obvious inaccuracy of the humors in modern scientific light, it was a neat, closed system that seemed to explain the complicated nature of the human body for many generations of scholars and physicians.

The human body also had the obvious fundamental organs, which were thought to be formed from the seminal fluids. These included the stomach, intestines, bones, brain, nerves, eyes, ears, nostrils, tongue, limbs, muscles, heart, liver, spleen and sex organs. Not surprisingly, the Muslim scholar also acknowledged existence of a human soul and spirit. Human faculties, following Aristotle, were said to be natural, vital and psychological. Natural faculties included procreation, growth, nourishment, and excretion, among others. The psychological part of man included reasons and thought, as well as perception and movement. The final part of man comprised the functions, referring to both attraction and repulsion of fluids and material in the body.

t was taken for granted that the reader knew how the first man, Adam, was created out of the dust of the ground and given a soul by God. The Quran refers to the creation of Adam in several places and a tradition related to Muhammad tells how Adam was said to be created during the last hour of the sixth day of creation. The issue of how children came to be formed in human reproduction was another matter altogether and one not properly understood anywhere until the 19th century. The ideas from the classical tradition, which unfortunately were not very accurate, greatly influenced Islamic science. Aristotle had argued that male semen was the sole fashioner of the human foetus with the role of the female relegated to that of a mere vessel. Hippocrates, on the other hand, claimed both male and female contributed to the developing embryo. Muslim scholars sided with Hippocrates, whom we now know was right on this matter, with important consequences, particularly for laws regarding the practice of contraception.

In analyzing the stages of the foetus, Muslim scholars had a Qur’anic base to build on. In the chapter on The Pilgrimage (22:5) God said: “O people, if you are in doubt concerning being raised up again, then consider that We created you from the dust, then from a spermdrop, then from clotted blood, then from a lump of flesh, formed and unformed. We cause that which We will to stay in the wombs for an appointed term, then We bring you forth as babes; then We cause you to grow that you may attain to your full strength.” Scholars interpreted this verse, following a tradition related to Muhammad, to mean that there were three periods of 40 days each for the developing embryo. The first lasted forty days from conception and was called a drop of semen. The second was a blood-like clot and the third was a lump of shape. At the end of these 120 days, or in the fourth month of pregnancy, it was believed that the body became ensouled; it was fully human.

For several major Muslim jurists abortion was allowed up until the end of the fourth month, although the majority of schools of religious law viewed the embryo as a destined child and thus frowned upon, even if they did not prohibit, abortion at any time. Contraception, however, was a different matter and was generally agreed upon as legitimate up until the end of the fourth month. Indeed, historical evidence suggests that medieval Muslims quite consciously practiced birth control in times of famine and political chaos. The herbals are quite explicit regarding herbs thought to have contraceptive capabilities. The famous medical text Hawi by Rhazes, a 9th century Persian scholar, lists over 50 contraceptive methods, including varieties of suppositories and tampons. Most of the methods called for the female to use some sort of oil, which can physically clog and thus reduce movement of sperm. At the time of Muhammad it is apparent that coitus interruptus was widely practiced, especially with slave girls. Although the prophet did not forbid this method of contraception, he did say in a tradition that it could only be done with the permission of the woman. Since Islam recognized the role of the female as well as the male in producing life, the woman was given the right to decide whether or not sex would lead to a child.

for Part One, click here.

Daniel Martin Varisco