Wednesday, 20 August 2008


It upsets many of us that God has been displaced by ‘Mother Nature’ in almost all scientific discussions of the present time. I do not aim to argue that God exists through the argument of design – the existence of God cannot be proved by means of all these arguments. The existence of God is inferred through a ‘leap of faith’, the like of which was described by the Danish philosopher Soren Kierkegaard. The argument from design, which aims to be a scientific argument, has been demolished not by Darwin, as many of his advocates currently suppose, but by David Hume and Immanuel Kant years before Darwin, the former that criticizing “the logic of using apparent design in nature as positive evidence for the existence of a God. He did not offer any alternative explanation for apparent design, but left the question open.” But it is a matter of faith – science cannot prove to anyone that, if we have a computer in the middle of an empty desert that there is someone behind it, but my own faith tells me so. Science cannot prove to me that my seeing the sun rise from the East everyday will mean it will arise from there tomorrow. Science is based on induction, and as such carries room for uncertainty. Faith in God ought to be certain, unshaken, unmovable, and as such can only be fideistic. The great Ibn Arabi, one of the greatest mystics of history remarked, “God is the evidence for the Creation, and we ought never to think that the Creation can be a proof for God, precisely like we say that light demonstrates the day. We can never say that day proves the existence of light”. Dr. Mustafa Mahmoud, the great Egyptian thinker explained the Hadith Qudsi, “I am the proof for everything, and there is no proof for me”, “God is the self evident truth that is apparent in everything, in the organization, precision, beauty and mastery of the tree leaf, in the feathers of the , in the wings of the butterfly, in the scent of the rose, in the singing of the morning bird, in the heavens and the earth, in this glorious symphony which we call the Universe” .

However, for one who already believes in God, medicine can certainly strengthen the faith of the believer by highlighting the great design therein. The argument from design, while philosophically invalid, is extremely powerful and provokes great intellectual delight in the believer. Nevertheless, it ought to serve the believer not as a proof for the existence of God, but merely as a way of strengthening already existing belief.

Unfortunately, the biggest attack in our age on the argument from design comes not from philosophy, but ‘science’, namely the theory of evolution. This theory aims to provide the ‘alternative explanation’ that Hume left out of his critique of theism. As Professor Richard Dawkins, arguably the most famous proponent of the theory of evolution in our time remarked in his book, ‘The Blind Watchmaker’:

“An atheist before Darwin could have said, following Hume: 'I have no explanation for complex biological design. All I know is that God isn't a good explanation, so we must wait and hope that somebody comes up with a better one.' I can't help feeling that such a position, though logically sound, would have left one feeling pretty unsatisfied, and that although atheism might have been logically tenable before Darwin, Darwin made it possible to be an intellectually fulfilled atheist.”

Only those who look at it superficially would regard the theory of evolution as it stands in the eyes of its ‘experts’ these days, as an idea compatible with a faith in God, the designer, the originator and great Architect of the heavens and the earth and all that is in between. I believe people like Pope John Paul II, who “sent out a letter endorsing not just evolution per se, but modern theories of organic change”, to be as superficial as Keith Ward, Regius Professor of Divinity at Oxford, who spoke of natural selection as a “simple and extremely fruitful theory…that that there is every reason to think that a scientific evolutionary account and a religious belief in a guiding creative force are not just compatible, but mutually reinforcing”.

No. That is not the message of the theory of evolution as it stands. We can deceive ourselves into believing otherwise, but that is not the truth.

Michael Ruse, a professor of philosophy at Florida State University, put it clearly in the chapter entitled, ‘Belief in God in a Darwinian age’ in ‘The Cambridge Companion to Darwin’, “Following Darwin himself, the defining mark of Darwinism today is the commitment to explain apparent design as the product of natural law operating blindly. If you are a Darwinian, then above all you believe that the abundant design-like features of the world are due to natural selection. For some scientists, this commitment is the ultimate issue.” In an essay entitled ‘Darwin’s Revolution’, Francisco Ayala of the University of California remarked that, “natural selection excludes God as the explanation accounting for the obvious design of organisms”. Daniel Dennett, the American philosopher praised Darwinism as a “universal acid that corrodes traditional spiritual and moral beliefs”. Cornell biologist William Provine stated in one televised debate that, “Consistent Darwinism implies no life after death, no ultimate foundation for ethics, no ultimate meaning for life, no free will”.

Harun Yahya, the Turkish philosopher and Islamic thinker, is therefore not mistaken when he remarks, as he does in so many of his works, that “the real target of Darwinism is religion”, although I think he does exaggerate a bit when he says that “Darwinism provides the sole so-called scientific ground for all anti-religionist ideologies that cause misery for mankind, such as fascism, communism, and imperialism, and legitimized the merciless practices of those who adopted these philosophies”, and find his obsession with the subject rather silly (virtually all his books, which vary in their topic of discussion from Palestinian and Chechnyan politics to the biographies of the Prophet’s and their companions, all of them end with a section on the theory of evolution!). He is however, arguably the world’s biggest opponent of this theory, and it is worthwhile listening to what he has to say on the subject, or reading his widely available works (available online free on his website).

He remarks that, “evolutionists do not believe in God, for they have made a deity out of chance and totally oppose the fact of creation” and that “Darwinism is not a scientific thesis; rather, it is a system of thought designed to lead people to deny God”. He believes that, while it lacks sufficient scientific evidence, “Muslims must understand that it is totally mistaken to believe that Allah created the universe and yet support the theory of evolution despite the lack of hard scientific evidence. Furthermore, it is just as mistaken to claim that evolution is compatible with the Qur'an by ignoring all the warnings in the Holy Book itself. Muslims who adopt such a position must realize that they are supporting an idea designed to help materialist philosophy and that, given this fact, they must withdraw their support at once”. He quotes extensively from the works of the great astrophysicist Fred Hoyle, who felt that belief in random chance and blind evolution is largely psychological, saying “such a theory (that life was assembled by an intelligence) is so obvious that one wonders why it is not widely accepted as being self evident. The reasons are psychological rather than scientific”.

I cannot help but agree with Yahya in all that he says here. Interestingly, Yahya’s viewpoint was preceded by many Islamic thinkers before him, such as Sayyid Qutb, who expressed it in his most popular book, ‘Milestones’. As explained by one of his analysts, Ahmad Bouzid:

“Qutb’s favorite example of a science transgressing its legitimate boundaries is Darwinism: "Darwinist biology goes beyond the scope of its observations, without any rhyme or reason, and only for the sake of expressing an opinion, in making the assumption that to explain the beginning of life and its evolution, there is no need to assume a power outside the physical world."Darwinism is "scientific ignorance" and the unforgivable sin it commits is that of infringing on God’s haakimiyyah. Qutb does not seem to be offended so much by the actual content of the theory — of which he treats only tangentially — but rather by the proposition underling the theory: i.e., that a man, Darwin, took it upon himself to explain the origins of man's existence. Only the word of God may explain man's existential questions: "the secret of his existence and the secret of the universe surrounding him."A second sin seems to deeply offend Qutb: Darwinism's demotion of man from his status of privileged being, reducing him "to be nothing more than an animal, or even than inorganic matter!” Instead of God's caretaker, man is reduced to the lowest level of existence: mere matter.”

However my opposition to the current theory of evolution, that great disaster to the idea of God the designer, stems not from any knowledge of its many claimed scientific deficiencies – the poverty of the fossil record, which was described by T. Neville George, a professor of paleontology of Glasgow University, in the following words, “There is no need to apologise any longer for the poverty of the fossil record. In some ways, it has become almost unmanageably rich and discovery is outpacing integration... The fossil record nevertheless continues to be composed mainly of gaps” and Mark Czarnecki, a prominent evolutionary paleontologist writing in an article, ‘The Revival of the Creationist Crusade’, “A major problem in proving the theory has been the fossil record; the imprints of vanished species preserved in the Earth's geological formations. This record has never revealed traces of Darwin's hypothetical intermediate variants – instead species appear and disappear abruptly, and this anomaly has fueled the creationist argument that each species was created by God” or other details which I do not profess to understand. My main opposition to the randomness of the theory of evolution stems from a firm belief in the ideas of the intelligent design movement. As a doctor, I have relied immensely on their ideas to bring medicine to life so to speak, and to show that it is full of examples of ‘irreducible complexity’ and intelligent design for the human body to be brought about by blind chance. I hasten to add that the Intelligent Design (ID) movement has indeed served to deliver the biggest blows to the theory of evolution and the Darwinian enterprise in recent years.

Because evolution, as currently portrayed, so clearly leads to atheism, and is taught as established fact in biology school curricula, the current absence of any mention of the God in medical literature these days is not to be unexpected. Most doctors and medical students do not spend much time reflecting on the philosophical implications of what they are taught, possibly because of a lack of time. And they may be excused for this over the less controversial topics in science. But a theory like Darwin’s needs an attentive, critical view, like that provided by the Intelligent Design (ID) movement.


The anti-evolution ID movement was established only in the last fifteen years, and has been trying to show that the nature and structure of the material world and all living things show evidence of being ‘intelligently designed’, according to some well thought out pattern. Professor William Dembski, one of the pioneers of the movement, defined ID most comprehensively as follows:

“Intelligent design is three things: a scientific research program that investigates the effect of intelligent causes, an intellectual movement that challenges Darwinism and its naturalistic legacy, and a way of understanding divine action. Intelligent design therefore intersects science and theology”

One of the many attractions of intelligent design is that it is not a philosophical or theological movement biased to any faith, but is scientific and critically dependent on evidence found in nature. All it says is that there is intelligent design (as opposed to apparent design which is in fact a consequence of natural laws (such as the lattice structure of diamonds or a salt crystal)) in nature, leaving out the identity of the designer. As stated on one intelligent design website, “the scientific theory of intelligent design simply cannot identity the designer because it is not a question which can be addressed through the methods of science”. Thus the theory of intelligent design appeals to theists of all faiths. Another website gave a list of “persons with the following beliefs who could embrace ID”, to include monotheists, duotheists (e.g. Zoroastrians who believe in two deities), Trinitarians, henotheists (e.g. a Hindu who believes in many Gods and Goddesses who are aspects of a single deity, Brahman), polytheists (e.g. followers of many of the Aboriginal religions in the world who believe in many Gods and Goddess as discrete entities.), deists who believes that God created the universe, set it in motion, left, and has not been seen since and atheists, agnostics, humanists, or anyone else who might hold open the possibility of a very advanced species of intelligent beings existing in the universe.

One of the central pillars of the intelligent design movement is the concept of irreducible complexity, which was first defined by Professor Michael Behe of Lehigh University in his book, ‘Darwin’s Black Box’, as follows:

By irreducibly complex I mean a single system composed of several well-matched, interacting parts that contribute to the basic function, wherein the removal of any one of the parts causes the system to effectively cease functioning. An irreducibly complex system cannot be produced directly (that is, by continuously improving the initial function, which continues to work by the same mechanism) by slight, successive modifications of a precursor system, because any precursor to an irreducibly complex system that is missing a part is by definition nonfunctional. An irreducibly complex biological system, if there is such a thing, would be a powerful challenge to Darwinian evolution. Since natural selection can only choose systems that are already working, then if a biological system cannot be produced gradually it would have to arise as an integrated unit, in one fell swoop, for natural selection to have any thing to act on

The concept of irreducible complexity, which argues that biological systems are an all-or-none phenomenon, i.e. their functional capacities are only attained when all the components are in place at the same time, delivers a most incisive blow to the theory of evolution and its advocates, because the theory of evolution is based on the premise that it occurs primarily by “numerous successive slight modifications”. As Darwin himself confessed, “if it could be demonstrated that any complex organ existed which could not possibly have been formed by numerous, successive, slight modifications, my theory would absolutely break down."

Of course, one can argue that a gradual process can account for irreducible complexity. For instance, the classic example of irreducible complexity that Behe cites, the mousetrap, can be designed by bringing the platform, hammer, spring, catch and holding bar at gradual intervals (figure 1). As stated by Dembski, “Given a prespecified goal, selection has no difficulty producing irreducibly complex systems”. However the selection process that the evolutionists believe in “operates without goals, has neither plan nor purpose, and is wholly undirected”. It is blind, and they call nature the ‘blind watchmaker’ in reference to William Paley’s famous design argument for the existence of God.
Figure 1 – The Mousetrap. Some scientists use the mousetrap as an example of an irreducibly complex machine. The mousetrap has 5 essential parts: a hammer, a spring, a catch, a platform, and a holding bar. If any parts are missing, the trap will be unable to perform its function: catching mice!
Because of its sheer conceptual power and versatility, the idea of irreducible complexity should be more widely known among theists. Over the years, members of the intelligent design movement have given us hundreds of examples of irreducible complexity in all fields of scientific endeavour, including biology, biochemistry, astrophysics and chemistry. It is time to disclose the Hand Of God in one more field, which was referred to once by the famous Nobel Prize winning surgeon Alexis Carrel, as the “most comprehensive of all the sciences concerning man” - medicine.


The aims of this book are five. Firstly, it is an attempt to bring back God into the world of medicine, to write a medical textbook where His Glory and intelligent design is highlighted, and His Praises are sung for the first time in the English language, and with that, the greatest delight to the monotheistic soul. It aims to show that we can learn so much about Him from its study, in the spirit of the following reported Hadith Qudsi, “"God says, ‘I was a hidden treasure, and I wished to be known, so I created the creation, through it I will be known”. In the first chapter of this work, I aim to show the flaws of the current approaches to this fascinating subject, and how it ought to be approached most appropriately.

Secondly, it is an attempt at demonstrating that there is a lot more to medicine than the dull, exploitative world that I have described above. Besides being philosophically and theistically intriguing, I propose to show that medicine can be aggrandised as Alexis Carrel, the great French surgeon nearly a century ago, into a true multidisciplinary field, involving all professions and all of knowledge. As he states in his wonderful ‘Man the Unknown’:

“Medicine is the most comprehensive of all the sciences concerning man, from anatomy to political economy. However, it is far from apprehending its object in its full extent. Physicians have contented themselves with studying the structure and the activities of the individual in health and in disease, and attempting to cure the sick. Their effort has met, as we know, with modest success. Their influence on modern society has been sometimes beneficial, sometimes harmful, always secondary…Medicine has been paralyzed by the narrowness of its doctrines. But it could easily escape from its prison and help us in a more effective manner. Nearly three hundred years ago a philosopher, who dreamed of consecrating his life to the service of man, clearly conceived the high functions of which medicine is capable. "The mind," wrote Descartes in his Discourse on Method, "so strongly depends on temperament and the disposition of bodily organs, that if it is possible to find some means which will make men generally more wise and more clever than they have been till now, I believe that it is in medicine one should seek it. It is true that the medicine now practiced contains few things having so remarkable a usefulness. But, without having any intention of scorning it, I am confident that there is no one, even among those whose profession it is, who does not admit that everything already known about it is almost nothing in comparison with what remains to be learned, and that people could be spared an infinity of diseases, both bodily and mental, and perhaps even the weakening of old age, if the causes of those troubles and all the remedies with which nature has provided us were sufficiently well known." Medicine has received from anatomy, physiology, psychology, and pathology the more essential elements of the knowledge of ourselves. It could easily enlarge its field, embrace, in addition to body and consciousness, their relations with the material and mental world, take in sociology and economics, and become the very science of the human being. Its aim, then, would be not only to cure or prevent diseases, but also to guide the development of all our organic, mental, and sociological activities. It would become capable of building the individual according to natural laws. And of inspiring those who will have the task of leading humanity to a true civilization. At the present time, education, hygiene, religion, town planning, and social and economic organizations are entrusted to individuals who know but a single aspect of the human being. No one would ever dream of substituting politicians, well-meaning women, lawyers, literary men, or philosophers for the engineers of the steel-works or of the chemical factories. However, such people are given the incomparably heavier responsibility of the physiological, mental, and sociological guidance of civilized men, and even of the government of great nations. Medicine aggrandized according to the conception of Descartes, and extended in such a manner as to embrace the other sciences of man, could supply modern society with engineers understanding the mechanisms of the body and the soul of the individual, and of his relations with the cosmic and social world.

This superscience will be utilizable only if, instead of being buried in libraries, it animates our intelligence. But is it possible for a single brain to assimilate such a gigantic amount of knowledge? Can any individual master anatomy, physiology, biological chemistry, psychology, metapsychics, pathology, medicine, and also have a thorough acquaintance with genetics, nutrition, development, pedagogy, esthetics, morals, religion, sociology, and economics? It seems that such an accomplishment is not impossible. In about twenty-five years of uninterrupted study, one could learn these sciences. At the age of fifty, those who have submitted themselves to this discipline could effectively direct the construction of the human being and of a civilization based on his true nature. Indeed, the few gifted individuals who dedicate themselves to this work will have to renounce the common modes of existence. They will not be able to play golf and bridge, to go to cinemas, to listen to radios, to make speeches at banquets, to serve on committees, to attend meetings of scientific societies, political conventions, and academies, or to cross the ocean and take part in international congresses. They must live like the monks of the great contemplative orders, and not like university professors, and still less like business men. In the course of the history of all great nations, many have sacrificed themselves for the salvation of the community. Sacrifice seems to be a necessary condition of progress. There are now, as in former times, men ready for the supreme renunciation. If the multitudes inhabiting the defenseless cities of the seacoast were menaced by shells and gases, no army aviator would hesitate to thrust himself, his plane, and his bombs against the invaders. Why should not some individuals sacrifice their lives to acquire the science indispensable to the making of man and of his environment? In fact, the task is extremely difficult. But minds capable of undertaking it can be discovered. The weakness of many of the scientists whom we meet in universities and laboratories is due to the mediocrity of their goal and to the narrowness of their life. Men grow when inspired by a high purpose, when contemplating vast horizons. The sacrifice of oneself is not very difficult for one burning with the passion for a great adventure. And there is no more beautiful and dangerous adventure than the renovation of modern man.” (My highlighting).

This same belief has been expressed by many other physicians and surgeons throughout the ages, although sadly it is not as commonly expressed in this day and age, thanks to the decline in our reflective faculties. The great Irish surgeon, Abraham Colles, whose name is immortalised in the all too common Colles fracture, remarked in his ‘Treatise of Surgical Anatomy’, “Be assured, that no man can know his own profession perfectly, who knows nothing else; and that he who aspires to eminence in any particular science must first acquire the habit of philosophising on matters of science in general.”

William Osler, the great Canadian physician put it like this in an essay ‘Chauvinism in Medicine’, in his ‘Aequanimitas’, “In no profession does culture count for so much as in medicine, and no man needs it more than the general practitioner.”

Although my aims are a far cry from the megalomaniac dreams of Carrel, I do indeed aim to show that medicine is wider than commonly thought. I hope to use medicine as a carrier, if you like, of other interesting fields of knowledge, to entertain the reader, and place medicine within the wider scheme of things. I wish to exhibit medicine as an integral part of scientific, philosophical, social and political life, not as the isolated speculations and practices of random physicians. I will attempt to connect the various medical problems that I discuss with aspects of everyday life, to show that medicine is connected with some of our deepest notions about life. In this way, medicine would be regarded as something that transcends traditional boundaries and an intellectual, as well as practical, exercise and art. I hasten to add that this is not a foreign idea

Another of its aims is to reinforce the fun factor in medicine. By viewing medicine within the wider context, looking at its impact on history, famous figures, and vice versa, we learn much that is fascinating. Teaching with the 'fascinating case' has a long tradition in medical education and has a popularity that extends beyond medical audiences. At their best, such stories serve more than a didactic purpose - they provide a glimpse of the diversity of human experience and the moral and social dimensions of illness.

In particular, I have tried to incorporate as many artists’ depictions of disease as I possibly could, in the firm belief that, being naturally endowed with a greater power of description than most other people, their views of disease are those that would be most vividly recalled by the reader. Take for instance Anton Chekhov’s (also a medical man) description of his bouts of haemoptysis due to the tuberculosis that eventually killed him. Fyodor Dostoyevsky’s struggles with epilepsy, Benjamin Franklin’s gouty agonies, Jane Austen’s descriptions of her presumed Addisonian crises, and Ludwig von Beethoven’s tears of anguish over his deafness. Nothing that I have read in the medical textbooks available at present compares to the power of the images by which those greats portrayed their illness. This work is full of extracts from their works or statements, in the hope that they will have a similar impact on the reader.

In addition, realising that some figures, typically associated with certain symptoms, had, or possibly had (after all, there is much conjecture in all of history, let alone medical biography) certain disorders, may reinforce the rarer aspects of some diseases. For example, much is written at present of the possibility of Beethoven (a figure immortalised to the layman by his majestic music and deafness, and from the medical perspective with his ascites and multiple paracenteses) suffering from sarcoidosis. On knowing this, one immediately learns three things about sarcoidosis – that it is a multisystemic disorder, that it can affect the liver (though it is certain the alcohol did the greater part of the damage), and also hearing – more specifically the vestibulocochlear nerve. Knowing that his autopsy showed renal calculi will also help recall sarcoidosis as an important cause of hypercalcaemia.

Awareness of how celebrities have endured certain diseases can help in several other ways. The following extract, from Bower and Waxman’s ‘Lecture Notes On Oncology’, summarises these well; although it relates mainly to oncology, it can certainly be applied to other fields too:

“Celebrities influence public perceptions and behaviour inordinately, and this is true in oncology as elsewhere. Celebrities with cancer have contributed in three main ways; personal accounts bring patients’ experiences into the limelight, reports of celebrity patients increase public awareness and may encourage health-seeking behaviour such as stopping smoking, and celebrity patients may support cancer charities and encourage donations. Prominent examples of patient’s perspectives include John Diamond’s account in 'C: because cowards get cancer, too' and Ruth Picardie’s 'Before I say goodbye', both moving accounts by accomplished journalists. Celebrity patients can influence the treatment choices that the public make. Following Nancy Reagan’s mastectomy for localized breast cancer in 1987, there was a 25% fall in American women choosing breast-conserving surgery over mastectomy. Her husband’s successful surgery for Dukes’ B colon cancer while president in 1984 increased awareness and propelled the warning signs of colon cancer into the media. Successful cancer treatment is often most widely publicized, and no article describing Lance Armstrong’s cycling victories seems complete without a mention of his treatment for metastatic non-seminomatous germ cell tumour, or of his two children conceived with stored sperm banked prior to chemotherapy. Other celebrity patients have used their wealth and fame to establish and support charitable projects to support cancer research and treatment, including Bob Champion, the steeple-chase jockey treated for testicular cancer in the 1970s, and Roy Castle, a lifelong non-smoker who was diagnosed with lung cancer in 1992. Of course, no one is immune to cancer, even rock stars whose deaths are traditionally associated with suicide and substance abuse”.

The fourth aim of this work is to oppose the current trend of increasing ‘scientification’ and complexity of medicine and the basic medical sciences. I have been to many medical lectures, where the speaker spends an hour or so dealing with the scientific minutiae of diseases. I always found nearly all of these lectures extremely dull. But this is not a criticism of the speakers; it is a natural consequence of the increasing ‘specialisation’ of medicine. Unless complicated scientific ideas are grounded in philosophical concepts or aspects of everyday life, I find them a lot less exciting or indeed memorable. By relating them to the questions of life that matter most to us, many of which are essentially the substance of philosophy, they will inevitably be a lot more memorable, and much more stimulating. I aim to analyse, as well as synthesise medicine, as I have studied it, into a coherent whole. I cannot help but quote the great (though at times controversial) Alexis Carrel again on this issue:

“Still more harm is caused by the extreme specialization of the physicians. Medicine has separated the sick human being into small fragments and each fragment has its specialist. When a specialist, from the beginning of his career, confines himself to a minute part of the body, his knowledge of the rest is so rudimentary that he is incapable of thoroughly understanding even that part in which he specializes. A similar thing happens to educators, clergymen, economists, and sociologists who, before limiting themselves entirely to their particular domain, have not taken the trouble to acquire a general knowledge of man. The more eminent the specialist, the more dangerous he is. Scientists who have strikingly distinguished themselves by great discoveries or useful inventions often come to believe that their knowledge of one subject extends to all others. Edison, for example, did not hesitate to impart to the public his views on philosophy and religion. And the public listened to his words with respect, imagining them to carry as much weight on these new subjects as on the former ones. Thus, great men, in speaking about things they do not thoroughly understand, hinder human progress in one of its fields, while having contributed to its advancement in another. The daily press often gives us the dubious benefit of the sociological, economic, and scientific opinions of manufacturers, bankers, lawyers, professors, physicians, whose highly specialized minds are incapable of apprehending in their breadth the momentous problems of our time. However, modern civilization absolutely needs specialists. Without them, science could not progress. But, before the result of their researches is applied to man, the scattered data of their analyses must be integrated in an intelligible synthesis.

Such a synthesis cannot be obtained by a simple roundtable conference of the specialists. It requires the efforts of one man, not merely those of a group. A work of art has never been produced by a committee of artists, nor a great discovery made by a committee of scholars. The syntheses needed for the progress of our knowledge of man should be elaborated in a single brain. It is impossible to make use of the mass of information accumulated by the specialists. For no one has undertaken to coordinate the data already obtained, and to consider the human being in his entirety. Today there are many scientific workers, but very few real scientists. This peculiar situation is not due to lack of individuals capable of high intellectual achievements. Indeed, syntheses, as well as discoveries, demand exceptional mental power and physiological endurance. Broad and strong minds are rarer than precise and narrow ones. It is easy to become a good chemist, a good physicist, a good physiologist, a good psychologist, or a good sociologist. On the contrary, very few individuals are capable of acquiring and using knowledge of several different sciences. However, such men do exist. Some of those whom our scientific institutions and universities have forced to specialize narrowly could apprehend a complex subject both in its entirety and in its parts. So far, scientific workers devoting themselves, within a minute field, to prolonged study of a generally insignificant detail, have always been the most favored. An original piece of work, without any real importance, is considered of greater value than a thorough knowledge of an entire science. Presidents of universities and their advisers do not realize that synthetic minds are as indispensable as analytic ones. If the superiority of this kind of intellect were recognized, and its development encouraged, specialists would cease to be dangerous. For the significance of the parts in the organization of the whole could then be correctly estimated.”

The final aim of this work is to show that, just like the world needs submission to God (Islam), the medical world needs Him. In a truly Islamic world, governed by the principles of truth and justice, the patients would be better, the doctors would be better, and overall, we will all lead happier lives.

In short, this book is a set of intellectual, scientific, philosophical and religious ruminations over medical topics, and is full of attempts at finding out ‘why’ things are as they are. It will aim to remain true to the strictest philosophical traditions of the past, where philosophy was defined not as an ivory-tower field, isolated from reality, but, as defined by some, as “the study of humans and the world by thinking and asking questions. It is not part of science, because it is not an observation of things in the real world to find out how they work. Philosophy tries to answer important questions by coming up with answers about real things and asking "why?”. Philosophy encourages people to ask the reason behind everything. It is the speculation bit; when believed firmly without wavering and no scientific evidence, it is labeled faith. If strong scientific evidence abounds, it becomes science. In that sense, no one defined philosophy better than Sir Bertrand Russell, when he said in the introduction to his magnificent monument, and arguably the best introductory philosophy book, ‘The History of Western Philosophy’:

“Philosophy, as I shall understand the word, is something intermediate between theology and science. Like theology, it consists of speculations on matters as to which definite knowledge has, so far, been unascertainable; but like science, it appeals to human reason rather than to authority, whether that of tradition or that of revelation. All definite knowledge -- so I should contend -- belongs to science; all dogma as to what surpasses definite knowledge belongs to theology. But between theology and science there is a No Man's Land, exposed to attack from both sides; this No Man's Land is philosophy. Almost all the questions of most interest to speculative minds are such as science cannot answer, and the confident answers of theologians no longer seem so convincing as they did in former centuries...The studying of these questions, if not the answering of them, is the business of philosophy”.

The medical professional is in an extremely privileged position, in that he or she is engaged in some of the deepest philosophical questions that trouble mankind, sometimes much more directly than the philosopher himself. For who is it who diagnoses the beginning of life, and has the first encounter with death. Who is it who oversees the birth of a child, and his or her growth and development. Who is it who sees man at his frailest, and bears witness to God’s statement, “Man was created weak” (3:28)[15]

If I may mention the biggest aim of this work, it is to reawaken this beautiful thing called the sense of wonder, which is numbed so often by being adults who have seen things so regularly without contemplation over them, is the chief aim of this work. If one were to retain the sense of childlike wonder over medicine, and common disorders, I am sure medicine will advance at a far more staggering rate than it is, and certainly imparting that sense of wonder to its students would only excite them and motivate them to practice it with true passion.

Compared with the natural sciences, particularly physics, medicine is still in its infancy. Part of the problem, I think, is a lack of this ‘childlike wonder’ among doctors. This is probably a harsh criticism of doctors, as we are often engrossed in the practical care of patients, allowing little time to pause and reflect upon our practice. This contrasts with most physicists, who are daily engrossed with ‘understanding’ rather than practical problems. But there are practical physicists, involved in electrical and mechanical engineering aspects. Why should there not be a bunch of reflective physicians, who can spread the wonder of medicine around, while the more practical ones are occupied with their work? I feel it is necessary.

“We never cease to stand like curious children before the great mystery into which we were born,” wrote Einstein in a letter to a friend later towards the end of his life. Another physicist, Paul Heckert described his job as follows, “Physicists are the perpetual three year olds of science. They always ask: Why? Physics is about observing nature, from elementary particles to the entire universe, and wondering why and how it works. While enjoying the beauty of natural phenomena such as rainbows or dark star filled skies, physicists continue trying to understand how they work. Achieving this understanding enhances nature's beauty. The best physicists keep their childlike wonder while unraveling nature's mysteries. As Whitman's Learned Astronomer, they show "the charts and the diagrams, to add, divide and measure them" while continuing to wander off "in the mystical moist night-air, and from time to time [look] up in perfect silence at the stars"”. How wonderful would it be if we had a bunch of three year olds of medicine!?

And the sense of wonder of physicists has, over the past hundred years, been connected with a sense of higher cosmic purpose. Virtually all the great physicists have been involved, in one way or another, with questions that would have been regarded before as a matter of metaphysics. This has especially been the case in post-Victorian times; prior to that physicists lived in ‘metaphysical security’, and didn’t deal with the deep questions of life the way the 20th and 21st century physicist does. With the sense of loss that has pervaded humanity over the past century, physicists have been trying to find solutions and answers from their studies.

The sense of cosmic purpose that many physicists have been advocating over the past 100 years should, I feel, be analogously utilised by medical professionals. As I have just illustrated, the medical world is an absolute mess at the moment. It is my firm belief that the idea of God and divine involvement within it can impart to it a great deal of order, and with that a great delight to the medical professional and his or her patients. This is what Jacob Needleman, a professor of philosophy at San Francisco State University says on the issue:

“The fate of medicine in the contemporary era is testimony to the teaching contained in the symbol of the caduceus. The meaning of the art of medicine, like the very meaning of being alive, cannot be found through one force alone. When the contemporary physician complains that the meaning of his craft is being taken away from him – by such mundane influences as government intervention, legal restrictions, hospital data banks, and insurance companies – we need to hear this complaint in a special way, because it is the same for all of us. More and more, we are all becoming aware that our lives are being lived for us by influences that, however numerous they appear, are in fact only so many reflections of one kind of movement in the life of man, a movement toward externals, toward needs and gratifications that, however justified in their own right, become destructive when they pretend to represent the whole meaning of human life….The meaning of being a physician can only be recovered through a rediscovery of the question of the meaning of human life itself, the meaning of being alive.”

Only by knowing our purpose in life, that we were created to worship and glorify God, will medicine find its meaning, and the medical professional will find his lost soul. The atheist or agnostic has no higher purpose in life – for he or she do not believe anything exists outside that perceived by our five senses. This point can only be realised by incorporating the idea of God with discussions of medical problems.

And linking this sense of higher purpose with the sense of wonder, one reviewer reviewing Needleman’s fantastic book, ‘The Way of the Physician’, writes:

“The physician has become the dispirited pawn of a "medical arms race" in which financial considerations are taking precedence over the welfare of patients. Cut off from great ideas and awakening experiences, doctors are either complacent or riddled with tension. Addressing them directly, the author mourns: "You are dying in your tracks, and you know it." Medicine for the practitioner and the patient alike, this book says that we need to train doctors to be wise healers working on the heart, not mechanics who fix bodies. Carrying resonances of Robert M. Persig's ground-breaking Zen and the Art of Motorcycle Maintenance, it points to the physician's quest, now, as our own: to rediscover the moral wonder that will enable us "to do the right thing and do it well".

The best physician is one who addresses the body and mind of all his or her patients, and addresses the ideas that impact those two things within his community. He need not do this with drugs; in fact, he should go to drugs only as a last resort for illness of all types, physical and psychological. He knows that, “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity” (the WHO definition, “a definition which was ratified during the first World Health Assembly, and has not been modified since 1948”), and that this will not be achieved in the presence of so many astonishingly bad philosophies and ideas. Thus, in this work I may go off on a tangent here and there, discussing a philosophy or ideology which is connected directly or indirectly, in a very subtle or blatant fashion, so as to help achieve this purpose. (The same case applies of course for the female physician)

With that in mind, let us begin our journey into the medical world, and explore it by way of wonder. There is no more powerful tool for the recall of knowledge than associating it with an element of wonder and the happiness that comes with it. A recently published medical textbook states that, “Facts are most efficiently memorized as visual images, chunks, acronyms, rhymes, webs etc, and as we update our knowledge, we must first recall our pre-existing schema of the topic, and then peg the new data onto this internal structure” (Bentley, 2007). How about if this internal structure was that of happiness and wonder? Socrates remarked that “wisdom begins in wonder”. It is not a surprise that the Arabic words for wise man and physician are the same, (‘hakeem’), both of which also overlap with the word ‘Failasuf’ (philosopher) – from the Greek for ‘the love of wisdom’.

The methodology is this - I begin most discussions of diseases with a brief look at how they have impacted humanity, mainly by glances at their impact on history or historical figures and how the latter particularly coped with their illness. There is much to learn from the historical outlook, and it would enrich the present day medical student in more than one way. Most importantly, it makes the learning of medicine much more pleasurable and enthralling, and less dry than commonly seen in present day textbooks (is it just me or did the medical writers of the past really write more joyfully than their present counterparts?!)

A continuous search for and effort at making helpful mnemonics and memory aids is also another feature of this book. Medical mnemonics are becoming more and more popular with medical students, and several textbooks and websites have been designed to diffuse them. Indeed, they make learning fun, and easier. Several studies have shown that mnemonics can be “effective tools for efficacious rote memorization of facts, increasing memory performance by up to 40–50%” (Bouganim, Barankin & Freiman, 2006). I am not claiming that mnemonics can replace traditional methods of learning, but as outlined by Bouganim et al, “Good mnemonics can increase the speed and amount of retained factual information, especially during stressful situations, such as examinations. Self-made mnemonics are often particularly effective, as the time and creative energy devoted to their development result in increased recall. With increasing confidence and experience, physicians ultimately cease to rely on mnemonics as the concepts to be memorized become indoctrinated into practice”. This book incorporates all the helpful medical mnemonics that I have come across.

I then proceed with discussion of the various presentations of illness, highlighting the features I have discussed in the aforementioned section.

As is natural for a book like this, many of my personal opinions are expressed, and personal heroes have crept in and extensively quoted. I hope the reader will find no offence in this. Finally, if this book were to instill in the kind reader that sensational moment of wonder, the beautiful perception of the mystical, as Albert Einstein would have put it, its aims would have been achieved. I hope that God will accept this work as an act of gratefulness to Him, the source of all beauty and wonder.
[1] I am yet to see a suicide attempt that was triggered by something more serious than that.
[2] Bertrand Russell put it best, “Drunkenness is temporary suicide: the happiness that it brings is merely negative, a momentary cessation of unhappiness”.

[3] The Quran put it beautifully, “Already have We urged unto hell many of the jinn and humankind, having hearts wherewith they understand not, and having eyes wherewith they see not, and having ears wherewith they hear not. These are as the cattle - nay, but they are worse! These are the neglectful” (7:179).
[4] He also remarked, equally brilliantly, “It has been said that man is a rational animal. All my life I have been searching for evidence which could support this”
[5] We read the following verses of the Bible – Colossians (1:16) which says, "All things were created by him and for him." and Isaiah (43:21), “The people which I formed for Myself, that they might tell of My praise”. In the Quran, two similar verses embody that belief, “I have created not the jinn and men except that they should worship Me” (51:56-58) and, “So glorify the praises of your Lord and be of those who prostrate themselves (to Him). And worship your Lord until there comes unto you the Hour that is certain (i.e. death)” (15:98-99)).
[6] ‘Peace’ (Al-Salam) is one of the names of God, as is apparent from the following verse, “He is Allah–there is no god but Him. He is the King, the Most Pure, the Perfect Peace, the Trustworthy, the Safeguarder, the Almighty, the Compeller, the Supremely Great. Glory be to Allah above all they associate with him”(59:23). In addition, “In Arabic, Islām derives from the three-letter root س-ل-م, which means "to be in peaceful submission; to surrender; to obey; peace". Islām is a verbal abstract to this root, and literally means "submission/obedience," referring to submission to Allah”. Islam is about being at peace with oneself, and with others, through a continuous awareness of God.
[7] An interesting question is - why do people's descriptions of their symptoms not correlate with what we learnt in medical school and in the medical textbooks? Is it a language issue? I mean - most English people can't speak their own language properly now, and sharp and dull mean the same thing to them. And with the influx of immigrants (yes, like myself), whose first language is not English, the English language will be even more tarnished. Maybe it's that. Or maybe it’s just that symptom description is not a valid method of helping in diagnosis. Maybe ischaemic cardiac pains can be sharp in some, tearing in some, pleuritic in others, rather than the central crushing chest pain we are taught about in medical school. It would be most interesting if we have an evidence-based analysis of history taking. I am not aware of any major publication on this issue. What would be even greater is if we can have a scientific explanation for the nature of these pains. I mean, is there a scientific reason why cardiac pains should be central and crushing, rather than left sided and pleuritic? We have a good reason why it should radiate to the left arm, based on shared embryonic origins, but the reasons for these other features are never explained to us. I can easily give a few reasons just by thinking about the issue, but I don't know how accurate they are.

How beautiful would medicine be if we could deduce everything, including the nature of symptoms and their proper descriptions, from an understanding of normal anatomy and physiology? It would increase the power of history taking exponentially. Alas, that will never be the case, because the human body is so complex an organism- affected by so many factors - sociological and psychological as much as physiological, and contrary to what the Marxists believe, the historical materialists, we can never predict these two things.

[8] The Arab world is increasingly afflicted by diabetes and its ills, which can be explained by the thrifty genotype hypothesis. As explained by Raz et al (2008), “This phenomenon of shifting disease patterns, termed epidemiological transition, initially occurred in developed countries and subsequently spread to developing nations. Arthur Koestler coined the term 'Coca- colonization' to describe the impact of the lifestyle of Western societies on developing countries. The devastating results of intrusion by Western society into the lives of traditional living indigenous communities can now be seen across the globe”.

[9] May I just turn the reader’s attention to three quotes. The first from Noam Chomsky, writing in an article on ‘The Responsibility of Intellectuals’, “To what extent are the British or American people responsible for the vicious terror bombings of civilians, perfected as a technique of warfare by the Western democracies and reaching their culmination in Hiroshima and Nagasaki, surely among the most unspeakable crimes in history”. The second is from a BBC criticism website, which could have equally come out of the pen of the great Gore Vidal, “The Hiroshima bombing came at a time when the Japanese were negotiating peace with the USA. The United States however wanted to test its new weapon: demonstrating its power to the world, especially to the Soviets”. The third is from John Pilger, writing very recently in the ‘Guardian’, “The most enduring lie is that the atomic bomb was dropped to end the war in the Pacific and save lives. "Even without the atomic bombing attacks," concluded the United States Strategic Bombing Survey of 1946, "air supremacy over Japan could have exerted sufficient pressure to bring about unconditional surrender and obviate the need for invasion. Based on a detailed investigation of all the facts, and supported by the testimony of the surviving Japanese leaders involved, it is the Survey's opinion that ... Japan would have surrendered even if the atomic bombs had not been dropped, even if Russia had not entered the war and even if no invasion had been planned or contemplated."

The National Archives in Washington contain US government documents that chart Japanese peace overtures as early as 1943. None was pursued. A cable sent on May 5, 1945 by the German ambassador in Tokyo and intercepted by the US dispels any doubt that the Japanese were desperate to sue for peace, including "capitulation even if the terms were hard". Instead, the US secretary of war, Henry Stimson, told President Truman he was "fearful" that the US air force would have Japan so "bombed out" that the new weapon would not be able "to show its strength". He later admitted that "no effort was made, and none was seriously considered, to achieve surrender merely in order not to have to use the bomb". His foreign policy colleagues were eager "to browbeat the Russians with the bomb held rather ostentatiously on our hip". General Leslie Groves, director of the Manhattan Project that made the bomb, testified: "There was never any illusion on my part that Russia was our enemy, and that the project was conducted on that basis." The day after Hiroshima was obliterated, President Truman voiced his satisfaction with the "overwhelming success" of "the experiment"

[10] It is interesting to note that this may not be the case, as explained in ‘Harrison’s Principles of Internal Medicine’, “Descriptions of the use of microbial pathogens as potential weapons of war or terrorism date from ancient times. Among the most frequently cited of such episodes are the poisoning of water supplies in the sixth century B.C. with the fungus Calviceps purpurea (rye ergot) by the Assyrians, the hurling of the dead bodies of plague victims over the walls of the city of Kaffa by the Tartar army in 1346, and the spreading of smallpox via contaminated blankets by the British to the native American population loyal to the French in 1767”

[11] I am left rather bemused by how our media can be so skewed even in our supposedly neutral medical textbooks. Harrison’s has three chapters in the section on bioterrorism; the microbial bioterrorism and chemical bioterrorism sections begin with mention of “the tragic events of September 11, 2001” and “The use of sulfur mustard and nerve agents by Iraq against the Iranian military and Kurdish civilians, the sarin attacks in 1994–1995in Japan, and the terrorist strikes of September 11, 2001” respectively. The radiation bioterrorism section, written by Zelig A. Tochner, Ofer Lehavi and Eli Glatstein however, begins as follows, “Terror attacks using nuclear or radiation-related devices are an unequivocal threat in the twenty-first century and are capable of unique medical and psychological effects.” There is no mention of the great American crimes on the Japanese people. The message is clear; we will explore this further in the media section later.
[12] I have not talked here about problems such as plagiarism, dishonesty and other such aspects of medical students and doctors. But there are plenty of recent studies illustrating this, such as a recent BMJ study which involved 667 Dundee University medical students, which showed that, “The proportion of students reporting that they had engaged in or would consider engaging in the scenarios varied from 2% for copying answers in a degree examination to 56% (51-61%) for copying directly from published text and only listing it as a reference. About a third of students reported that they had engaged in or would consider engaging in the behaviour described in four of the scenarios: chatting about an objective structured clinical examination, writing “nervous system examination normal” when this hadn't been performed, lending work to others to look at, and copying text directly from published sources and simply listing the source in a reference list.”
[13] Martin Gardner stated in the final chapter of his brilliant, ‘The Whys of a Philosophical Scriviner’ (p.347), “I also believe…that one can drop out of a traditional religion such as Christianity without at the same time abandoning faith in a personal God or in life after death. Indeed, I believe that such a faith, unburdened by strange dogmas, is truer to the heart of what Jesus probably taught than the New Testament records indicate. Many of the doctrines of Paul would have astonished Jesus, just as Paul would have been amazed by some myths that became part of the gospels. And Jesus and Paul alike would surely have been bewildered – in my opinion, shocked – by most of the doctrines fabricated later by the Holy Roman Church” .

[14] As He (SWT) describes Himself, “Allah! There is no deity save Him, the Alive, the Eternal. Neither slumber nor sleep overtaketh Him. Unto Him belongeth whatsoever is in the heavens and whatsoever is in the earth. Who is he that intercedeth with Him save by His leave? He knoweth that which is in front of them and that which is behind them, while they encompass nothing of His knowledge save what He will. His throne includeth the heavens and the earth, and He is never weary of preserving them. He is the Sublime, the Tremendous (2:255)” and “He is Allah, than Whom there is no other Allah, the Knower of the Invisible and the Visible. He is the Beneficent, Merciful. He is Allah, than Whom there is no other Allah, the Sovereign Lord, the Holy One, Peace, the Keeper of Faith, the Guardian, the Majestic, the Compeller, the Superb. Glorified be Allah from all that they ascribe as partner (unto Him).He is Allah, the Creator, the Shaper out of naught, the Fashioner. His are the most beautiful names. All that is in the heavens and the earth glorifieth Him, and He is the Mighty, the Wise” (59:22-24).

[15] Indeed, Harun Yahya wrote an article on the issue, ‘The Weaknesses of Man’, which reads like a medical description of the human body. Highly recommended reading (see appendix).

1 comment:

Mohamed said...

Schacht asserts that hadiths, particularly from Muhammad, did not form, together with the Qur'an, the original bases of Islamic law and jurisprudence as is traditionally assumed. Rather, hadiths were an innovation begun after some of the legal foundation had already been built. "The ancient schools of law shared the old concept of sunna or ‘living tradition’ as the ideal practice of the community, expressed in the accepted doctrine of the school." And this ideal practice was embodied in various forms, but certainly not exclusively in the hadiths from the Prophet. Schacht argues that it was not until al-Shafi`i that ‘sunna’ was exclusively identified with the contents of hadiths from the Prophet to which he gave, not for the first time, but for the first time consistently, overriding authority. Al-Shafi`i argued that even a single, isolated hadith going back to Muhammad, assuming its isnad is not suspect, takes precedence over the opinions and arguments of any and all Companions, Successors, and later authorities. Schacht notes that:

Two generations before Shafi`i reference to traditions from Companions and Successors was the rule, to traditions from the Prophet himself the exception, and it was left to Shafi`i to make the exception the principle. We shall have to conclude that, generally and broadly speaking, traditions from Companions and Successors are earlier than those from the Prophet.

Based on these conclusions, Schacht offers the following schema of the growth of legal hadiths. The ancient schools of law had a ‘living tradition’ (sunna) which was largely based on individual reasoning (ra'y). Later this sunna came to be associated with and attributed to the earlier generations of the Successors and Companions. Later still, hadiths with isnads extending back to Muhammad came into circulation by traditionists towards the middle of the second century. Finally, the efforts of al-Shafi`i and other traditionists secured for these hadiths from the Prophet supreme authority.

Goldziher maintains that, while reliance on the sunna to regulate the empire was favoured, there was still in these early years of Islam insufficient material going back to Muhammad himself. Scholars sought to fill the gaps left by the Qur'an and the sunna with material from other sources. Some borrowed from Roman law. Others attempted to fill these lacunae with their own opinions (ra'y). This latter option came under a concerted attack by those who believed that all legal and ethical questions (not addressed by the Qur'an) must be referred back to the Prophet himself, that is, must be rooted in hadiths.These supporters of hadiths (ahl al-hadith) were extremely successful in establishing hadiths as a primary source of law and in discrediting ra'y. But in many ways it was a Pyrrhic victory. The various legal madhhabs were loath to sacrifice their doctrines and so they found it more expedient to fabricate hadiths or adapt existing hadiths in their support. Even the advocates of ra'y were eventually persuaded or cajoled into accepting the authority of hadiths and so they too "found" hadiths which substantiated their doctrines that had hitherto been based upon the opinions of their schools’ founders and teachers. The insistence of the advocates of hadiths that the only opinions of any value were those which could appeal to the authority of the Prophet resulted in the situation that "where no traditional matter was to be had, men speedily began to fabricate it. The greater the demand, the busier was invention with the manufacture of apocryphal traditions in support of the respective theses."

In summary, Goldziher sees in hadiths "a battlefield of the political and dynastic conflicts of the first few centuries of Islam; it is a mirror of the aspirations of various parties, each of which wants to make the Prophet himself their witness and authority." Likewise,

Every stream and counter-stream of thought in Islam has found its expression in the form of a hadith, and there is no difference in this respect between the various contrasting opinions in whatever field. What we learnt about political parties holds true too for differences regarding religious law, dogmatic points of difference etc. Every ra'y or hawa, every sunna and bid`a has sought and found expression in the form of hadith.

And even though Muslim traditionalists developed elaborate means to scrutinize the mass of traditions that were then extant in the Muslim lands, they were "able to exclude only part of the most obvious falsifications from the hadith material." Goldziher, for all his scepticism, accepted that the practice of preserving hadiths was authentic and that some hadiths were likely to be authentic. However, having said that, Goldziher is adamant in maintaining that:

In the absence of authentic evidence it would indeed be rash to attempt to express the most tentative opinions as to which parts of the hadith are the oldest material, or even as to which of them date back to the generation immediately following the Prophet’s death. Closer acquaintance with the vast stock of hadiths induces sceptical caution rather than optimistic trust regarding the material brought together in the carefully compiled collections.

From Daniel Brown Muslim Scholar from America

The relevance of the past: classical conceptions of Prophetic authority

The word sunna predates the rise of Islam and is well attested in pre-Islamic sources. The word sunna was likely to be applied to Muhammad even during his lifetime (p8).

The Quran never mentions sunna-al-nabi (sunna of the Prophet). The application of the term sunna is likely to be post-Quranic, especially when applied exclusively to Muhammad.

Early muslims did not give precedence of Muhammad's sunna over other sunnas, such as the sunna of the early caliphs or early companions. The sunna term was not exclusive to Muhammad. There were no rigid distinctions about sources of religious law, i.e. it wasn't concrete that Muhammad's sunna could be used as a source of law.

Shafi was born in 204 AH (193 years after Prophet Muhammad's death). He was the first to argue the Prophet's sunna as a source of law, identified to authentic prophetic hadith, and give it an equal footing to The Quran. Different attitudes to sunna existed during Shafi, al-kalam (a particular group or school of thought) rejected hadith altogether in favour of The Quran alone. Shafi's view was also oppossed early by schools of jurisprudence in Hijaz, Iraq and Syria, who applied the term sunna to Muhammad, his companions and the early caliphs as well.
After Shafi, it is rare to find the term sunna applied to other than Muhammad. Al-kalam argued the sunna of Muhammad should never be allowed to rule on The Quran and described the science of hadith (as in the methods used to collect hadith) as arbitrary. Evidence of this was the hadith was filled with contradictory, blasphemous and absurd traditions. [top]

Challenges to the view of the organic relationship between The Quran and sunna are not completely unprecedented in the history of Islamic thought. Some of the opponents of Shafi argued that The Quran explains everything (e.g. 16:89) and needs no supplement, this was because one of Shafi's central arguments was the need to clarify The Quran. This opposing viewpoint was snuffed out after the triumph of the traditionist view. However and it was not until the 19th and 20th centuries that the argument was seriously revived. One of the reasons Daniel Brown gives for the defeat of the opponents of Shafi was that they could not deny the authority of the Prophet. If for example, you found a hadith that was truly authentic then there is no way you can deny it because as it states in The Quran the Prophet was a very good example. Also, Shafi emphasised that to obey the Prophet was to obey God. Under this pressure, the opponents of Shafi were defeated. Rarely does the author address how specific arguments were defeated unfortunately, which was the most disappointing aspect of this book.

The question arose: how is it possible to determine which hadith were authentic and which were not?

In the 19th and 20th centuries, increased criticism and scrutiny by Western scholars of Islam showed Muslims that the hadith could not stand up to the criticism, whilst The Quran could. It made Muslims look back on the hadith and reflect more and examine their basis and origin in Islam.

The authenticity of hadith

The great compilations of the hadith took place in the 3rd century AH (i.e. beginning about 189 years after Prophet Muhammad's death, with the 6 books being complete about 280 years after his death), p83. In the eyes of most Muslim scholars sahih (reliable/authentic) hadith could with a high degree of confidence be considered to represent the actual words and deeds of the Prophet. On the other hand, few scholars would have argued the system was full proof. Any information in the hadiths was no absolute truth, it had to be classified as conjecture. The opponents of the hadith at the start were a minority. It was not seriously questioned.
Goldziher was unquestionably the most important 19th century critic of hadith. He became the first scholar to subject the hadith to a systematic historical and critical method. His study was published in 1896. Joseph Schacht "origins of Muhammadan jurisprudence" in 1950 was published. Like Goldziher, he concluded that few, if any traditions originated with the Prophet.
Even the Prophet recognised that there were people among his companions or those living during his lifetime were spreading lies about him. This is testified to in a hadith in Bukhari (p85). There is documented evidence that the companions disagreed with each other and criticsed each other, for example Aisha and Ibn Abbas were reported to have criticised Abu Hurayra. A number of companions demanded evidence for the truth of reports passed onto them. Umar alledgedly questioned a report from Fatima bint Qays. Umar is also reported to have confined three companions to Medina to keep them from spreading traditions. Abu Huyrara was only with the Prophet for 3 years, yet he is alledged to have been the most prolific in transmitting hadith. Biographical literature provides ample material for criticism for Abu Huyrara's character, Umar called Abu Huyrara a liar for example. Aisha criticised Anas for transmitting traditions as he was only a child during the life of the Prophet. And Hassan called both Umar and Zubair liars.

The process of hadith transmission was primarily oral, at least through the first century. Even after written collections of hadith were compiled, oral transmission remained the ideal (p88). Abu Rayya argues that the late date when traditions began to be registered in written form more than 100 years after the Prophet's death became a major obstacle to the fidelity of hadith (p89). Emerged in final form only in the 3rd and 4th centuries

Those who argue that Muhammad's companions began to record hadith in writing during his lifetime must explain the Prophetic prohibition on writing of hadith. Contradictions within the hadith exist regarding this subject. (p91)

Under orders from Caliph Hisham, Shihab al-Zuhri was first assigned to collect hadith. This tradition has commonly been taken to mean that al-Zuhri, under duress, became the first traditionist to violate the Prophet's prohibition on recording hadith in writing. Al-Zuhri is reported to have said: "We disapproved of recording knowledge until these rulers forced us to do so. After that reason we saw no reason to forbid the Muslims to do so." In other words, before al-Zuhri writing was the rare exception; after him writing of traditions became commonplace. This argument is bolstered by numerous accounts that early generations of pious Muslims, including not only al-Zuhri and traditionists like him but also the first four Caliphs, strongly disapproved of writing hadith.
The evidence strongly suggests that early generations of Muslims did record traditions in writing, however having reports about written records is rather different than having the records themselves. Thus, the apparent aversion of pious Muslims to the recording of hadith should be interpreted as reluctance to record an official, public collection of hadith. (p92)

Scholars agree that forgery of hadith took place on a massive scale. The science of hadith developed gradually as a response to this problem. The early written compilations called suhuf were little more than random transcriptions or personal collections. Muslim sources identify the first systematic collection in recording of the hadith with the Ummad Caliph Umar and with the scholars Abu Bakr. No such collection has survived. The earliest systematic collection is the muttawata of Mailk bin Anas, 179 AH (168 years after Prophet Muhammad's death), p94. Isnad (checking of transmissions) was not applied until after the early 2nd century AH according to Schacht. The book studies in early hadith literature stated it was earlier than this. For middle ground see Juynboll: "Muslim tradition". Major works of hadith (p161 footnote 70).

According to some, forgers of hadith became active even during the lifetime of the Prophet. In the Caliphate of Umar, the problem became so serious that he prohibited transmission of hadith altogether. The degree of the problem that resulted can be seen from the testimony of the muhahadithin (those who collect hadith) themselves. Bukhari selected 9000 traditions out of 700 000 (p96). When Bukhari reports that he selected from over 700 000 traditions, he is counting every different transmission chain, even when the substance of the tradition are the same (p99). The point is that hadith criticism did not begin during the 3rd century but was practiced continually from the time of the companions onwards (p99).