MEDICINE

MEDICINE

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MEDICINE. [This entry comprises two articles. The first considers the roots and development of traditional Islamic medicine and its historic interaction with methods of healing and curing in non-Islamic cultures. The second focuses on medical practices in modern Islamic societies and its relation to Western scientific values. For related discussion, see Natural Sciences.]

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Traditional Practice

Medical thinking and practice in a society are often viewed in terms of a dominant tradition; in the case of traditional Islamic societies, that dominant tradition was, for almost a millennium, a humoral system representing a revival of Greco-Roman medicine. But in Islamic society at large this was not the only alternative available, and it was never so dominant as to suffocate other medical views. Indeed, one must think in terms not only of multiple medical alternatives, but of intermingling options as well, since thinking most characteristic of one approach to medicine could simultaneously play a role in others as well.

For purposes of discussion here, three principal categories can be identified-a popular medical folklore that can be traced to remote antiquity, a mechanistic humoral tradition inherited from the Greeks, and a religious tradition focused on the person of the prophet Muhammad. These traditions differ in the areas they stress and the ways in which they are legitimated; but at the same time, there are significant degrees of overlapping and numerous shared ideas and beliefs. Islamic societies have tolerated them all in various ways and degrees, and overall, Islamic medical history presents a profoundly pluralistic face. Each of these traditions can be assessed in isolation but in the end only becomes meaningful in terms of the social context that allows all an important role.

Substrate of Popular Medicine. All societies possess a body of medical lore that makes sense to the members of that society and is considered efficacious by them, but that is legitimated not by formal structures of legal, scientific, or religious sanction but rather by established custom. In the Islamic world this “popular” medicine has roots in the usage and tradition of remotest antiquity, and certain customs still encountered today find their counterparts in, for example, ancient Babylonia or Egypt. This medical folklore is not specific to certain groups; it crosses religious and ethnic lines with little modification and may be encountered as fully among Christians as among Muslims, in settled as well as nomadic populations, and among Turks or Persians as well as Arabs.

Popular medicine in the Islamic world has always had both practical and magical dimensions. Cupping, venesection, and cautery were common procedures believed to be useful treatments for a wide range of disorders. Drug therapy consisted of an array of broths, elixirs, liniments, salves, and errhines (nasal powders), mostly prepared from herbal and other natural ingredients. Inorganic medicaments (such as minerals) are seldom encountered, but a wide range of animal products were used, including meat, gall, milk, and urine.

Many external and internal disorders were treated using these remedies, but little could be done in the case of serious physical injury; broken bones, for example, were massaged, rubbed with salves, and kept immobile to heal. Surgery was limited to simple procedures such as lancing boils, and any injury involving significant penetration of the body cavity was likely to be fatal.

Accompanying these measures was a broad range of animistic practices based on a belief-ubiquitous in premodern times-in the influence on personal health wielded by supernatural forces, especially the evil eye and spirit beings known as the jinn. To combat these powers, a vast array of charms, amulets, and talismans was used; stones, animal parts, or magical sayings were carried personally or kept in the home, and various charms and other magical procedures were used to seek protection, especially from epidemic disease, with which spirits were most closely associated. [See Magic and Sorcery.]

In the pre-Islamic period, this medical lore could be found in all the various pagan and monotheistic communities. Beginning probably in the eighth century, emerging circles of Muslim scholarship began to argue against some aspects of it in the form of traditions ascribed to the prophet Muhammad, but in the main the lore is still widely encountered in the Islamic world. Epidemic disease, for example, is still considered by many to be the work of the jinn; recourse to amulets and charms for medical purposes is widespread; and manuals on how to deal with supernatural afflictions are frequently published and widely distributed.

Greek Humoral Tradition. Greek medicine is prominently linked with the name of Hippocrates of Cos, a physician of the fifth century BCE (who may not have written any of the many works later ascribed to him); it reached its high point with the work of Galen (d. c.216 CE). This medical tradition viewed health as a state of balance among four “humors”-blood, phlegm, yellow bile, and black bile-embodying various combinations of four primary qualities: warmth, cold, heat, and dryness (yellow bile, for example, was characterized as dry and hot). All diseases and health problems, including psychological disorders, were explained in terms of excesses or imbalance in the interplay among these humors and qualities, and remedies were sought in treatments believed to have a contrary effect, which by restoring balance would also restore health. For an illness considered to represent imbalance toward the cold and moist, for example, drugs believed to have warming and drying properties would be used. Such factors as sleep, emotional states, exercise, eating and drinking habits, evacuation and retention, and environmental conditions were also recognized as influential, and all were integrated into the humoral system.

The great master of this humoral medicine was Galen of Pergamum, who wrote more than 35o books and lesser essays on it, and whose colossal reputation (rarely questioned until early modern times) attracted spurious attribution to him of some eighty or ninety further titles. In the centuries following Galen, humoral medicine as set forth in this massive corpus was widely practiced and taught, but by the late sixth century it had significantly declined, challenged by major social, economic, and other changes in the Near East which were disruptive to traditional classical culture in general. The rise of Islam could have had little influence on this process, which was already far advanced by the time of the Islamic conquests in the early seventh century. Indeed, it was within the context of the efflorescence of Islamic culture in the early `Abbasid caliphate (eighth to tenth centuries) that scholarship in general flourished, and that medicine, the sciences, and philosophy found special official favor. This solicitude was not so much for the practical utility of these fields as for their usefulness in confessional disputes with Christianity and (perhaps even more) with the dualist doctrines of Manichaeism.

In the ninth century, the revival of Greek humorial medicine was initially pursued by searching out and translating important Greek texts, especially those of Galen, either directly into Arabic or into Arabic through a Syriac intermediary. This translation movement not only made hundreds of medical works available in accurate Arabic renderings, but it also served to create a mode of discourse, complete with its own technical terminology, for pursuit of original medical research in Arabic.

Such research, already under way among the translators, produced a vast array of specialized monographs, comprehensive medical encyclopedias, teaching texts, commentaries, and popular self-help manuals through the medieval period. This scholarship was Galenic in inspiration and content, but the contribution of Islamic culture was nonetheless considerable. Major advances were made in pharmacology, ophthalmology, optics, and surgery, and certain ideas neglected by the Greeks (e.g., contagion) were raised to prominence only in Islamic times. Further, it was under Islamic auspices, and most particularly in the Canon of Medicine of Ibn Sina (known in the West as Avicenna, d. 1037), that the ideas of Galen, scattered through his many practical and theoretical works, were drawn together into a unified system. Latin translations of the Canon were the basis of the medieval European Galenism for the next six hundred years.

Many humoral medical authors and practitioners were Christians and Jews, but just as peoples of different religious persuasions adhered to essentially the same tradition of popular medicine, humoral writers and physicians all pursued the same Galenic tradition and produced works that were not specifically Muslim, Christian, or Jewish in orientation. Insofar as they had a religious agenda, it was usually of a general monotheistic character, and it is often impossible to determine the religious identity of a medical author from his works. This reflects a broader cosmopolitan outlook in Islamic society, at least where medicine was concerned: individuals sought out medical help, teachers, students, and books with little if any attention to religious affinities.

Humoral medicine was a system legitimated and sustained by its ancient scientific connections, by official patronage and support among elite groups, and by its role in intellectual and literary discourse among esteemed medical scholars. The presence of hospitals and collections of medical books, and eventually medical schools as well, also served to encourage humoral medicine as an urban-based system. Prominent at first in centers in the heartland of the Near East, it soon spread and was pursued with equal vigor and profit in the cities of Persia, Khurasan, and the Indian subcontinent in the East, and in Tunisia and Spain in the West. Both Persian and Turkish became vehicles for important medical scholarship, and from the fifteenth century on Istanbul was a major center for the study and teaching of humoral medicine.

The crucial roles played by the Islamic city and its political and social elites in nourishing humoral medicine can nowhere be seen so clearly as in the fact that the gradual impoverishment of urban centers and the declining power and prestige of their elites were accompanied by the recession of humoral medicine. This process was exacerbated by tendencies among political and administrative authorities of the nineteenth century and after to establish and promote medical institutions modeled after those of Europe, thus undercutting the social position of traditional humoral practitioners, their pedagogical and intellectual institutions, and their languages of scholarship.

The demise of humoral medicine was in many areas severe, but not complete. In the 1870s, when medieval Arabic medical encyclopedias were printed in the Islamic world (in Cairo) for the first time, this work was undertaken as a contribution to current medical scholarship, not medical history. Many of the herbal remedies of humoral medicine are still prepared today as-ironically enough-alternatives to modern Western biomedicine. And in India and Pakistan, where humoral medicine from the sixteenth century onward was associated with various saintly families and figures, it managed to survive under the rubric of yunani tibb (“Greek medicine”). It is still extensively studied and taught in this part of the Islamic world, and there its remedies are manufactured on a large scale and widely promoted and consumed.

Medicine of the Prophet. As discussions among Muslims led to the clearer definition and articulation of Islamic dogma and religious thought, many traditional practices and beliefs that had earlier aroused no objection gradually came to be regarded as suspect on religious grounds. Discussions on whether and in what ways these customs should be allowed to continue included debates on aspects of popular medical lore; and as in other such arguments, the authority of the Prophet was invoked by citing reports of sayings, deeds, or attitudes of his that reflected judgments on these matters. While it would be absurd to insist that Muhammad never said anything relevant to medicine-or that if he did, no one would have remembered it and then passed it down on his authority-the repeated reworking of the material and its problematic transmission make it impossible to discern any authentically prophetic core. But while most of the reports appear to represent discussions unlikely to predate the late seventh century (Muhammad died in 632), the fact remains that for more than twelve hundred years Muslims have viewed them as the genuine “Medicine of the Prophet.”

Early collections of this material loosely organize reports under discrete but often arbitrary headings and discuss a wide range of subjects, ranging from the curative power of honey (asserted in the Qur’an, 16.69) to the medical properties of wolf’s gall (an old popular remedy); whether or not one should flee from the plague or use passages from the Qur’an as charms; and whether ritually unclean or forbidden substances are. allowed to someone whom they might restore to health. These collections do not appear as independent works, but rather stand as chapters in larger compendia of h adith. The Iraqi scholar Ibn Abi Shaybah (d. 849) compiled the largest extant collection of this early material.

Stimulated by these medical chapters in hadith works, new medical reports cited from the Prophet continued to appear over the centuries and were collected into independent works, culminating in the Medicine of the Prophet by the Syrian jurist Ibn Qayyim al-Jawziyah (d. 1350). The genre came to incorporate both natural/ herbal and faith/magical remedies, an extensive materia medica, and ethical and moral advice on topics ranging from doctors’ fees to coitus and singing. Humoral physicians active in the formative stages of this literature seem to have despised it, but by the thirteenth century their objections had largely been overcome.

In modern times the Medicine of the Prophet has enjoyed great popularity; and as it is legitimated by direct appeal to the sanction of Muhammad himself, its social role is closely linked to the strength of prevailing religious sentiments. A recent edition of Ibn Qayyim alJawziyah’s work is a bestseller in the Arab countries, and a recent survey shows that among Muslims in general there is both awareness of the specific contents of the tradition and willingness to use it. Natural and herbal cures are employed for such complaints as headache, gastrointestinal disorders, and coughs, but just as prominent are faith/magic-oriented procedures, such as pronouncing a prayer or charm over a cup of water or milk and then drinking it to achieve the desired result.

This prominent corpus of medical lore sanctioned by the Prophet has probably played a significant role in sustaining discussions of medicine from an Islamic perspective. The Qur’anic attribution of curative power to honey, for example, became an important early topic in the Medicine of the Prophet; in modern times this is pursued not only in sizable works devoted to this subject, but further in books on the broader relevance of Islam, and Islamic scripture in particular, to modern medical issues. Medical journals and scientific publications in the Islamic world, though patterned after Western biomedical models, also take up such questions. Similar discussions are regularly laid before the general public in the press, which publishes the formal pronouncements (fatawa; sg., fatwa) of religious scholars on issues of medical ethics, including birth control, artificial insemination, autopsy, organ transplants and cosmetic surgery, euthanasia, and medical aspects of Islamic worship (e.g., whether one’s fast is broken by taking essential medication). Justifying precedents are almost always drawn from medieval Islamic legal texts.

Medical Pluralism. In a stimulating essay on cognitive aesthetics (“Gedanken zur kognitiven Asthetik Europas and Ostasiens,” Geschichte in Wissenschaft and Unterricht 12 [1990]: 735-744), Paul U. Unschuld observes that in China, medical options are viewed as complementary rather than exclusive: “not only/but also” as opposed to “either/or.” This characterization also applies to attitudes toward medicine in the Islamic world in medieval and modern times, and it highlights the fact that descriptive labels such as those used above should not be assigned determinative value or be regarded as defining insulated medical categories or epistemologies.

Some concluding examples may serve to clarify the nature and extent of this pluralism.

As observed above, the Medicine of the Prophet is defined in Islamic religious terms and comprises a distinct literary and scholarly genre. At the same time, however, it has firm connections to both popular and humoral medicine. Early works admit many magical customs and beliefs, and in one early text charms and incantations in fact account for the majority of the traditions it contains. In later centuries the influence of the humoral tradition is prominent, and such eminent personalities of Greek medicine as Hippocrates, Galen, and Dioscorides are all quoted and regarded with approval.

A similar attitude can be seen in humoral medicine. It is not uncommon to find that one physician began his career as an astrologer and fortuneteller, that another wrote a Medicine of the Prophet as well as works on humoral medicine and natural history, and that magical remedies appear in works which otherwise stand squarely within the Galenic tradition.

Such patterns pose important contradictions to an outsider, but from an internal perspective these lose much of their significance. As recent anthropological research shows, many societies readily accommodate multiple medical alternatives on a complementary basis, with little sense of fundamental conflict between them. Physicians trained in and practicing modern Western biomedicine, for example, may still wear charms and amulets for protection from spirits; a charm-peddler, however, may proceed directly to the Western-style clinic as soon as he becomes ill. Overall, popular medical folklore is followed because it is based on longestablished tradition (including its supernatural dimension), the Medicine of the Prophet because it invokes the authority of Muhammad among Muslim populations, humoral medicine because it is seen to represent an indigenous alternative with convincing Islamic credentials, and modern Western biomedicine because of its manifest efficacy and its associations with the authority of government and, in the end, modern science.

[See also Natural Science; Science.]

BIBLIOGRAPHY

Conrad, Lawrence I. “Arab-Islamic Medicine.” In Companion Encyclopedia of the History of Medicine, edited by W. F. Bynum and Roy Porter, vol. i, pp. 676-727. London, 1993. An effort to take a broader view of the medical history of the Islamic world, without the traditional bias in favor of the humoral tradition.

Conrad, Lawrence L, et al. The Western Medical Tradition, 800 B.C.-1800 A.D. Cambridge, 1995. Chapter 4 of this textbook treatment of the subject considers the Islamic tradition.

Dols, Michael W. Majnun: The Madman in Medieval Islamic Society. Oxford, 1992. Magisterial study of madness, with relevance to many other issues.

Elgood, Cyril. A Medical History of Persia and the Eastern Caliphate. Cambridge, 1951. Dated but still useful account of Islamic medicine, primarily in Persia.

Goitein, S. D. “The Medical Profession” and “Druggists and Pharmacists.” In his A Mediterranean Society: The Jewish Communities of the Arab World as Portrayed in the Documents of the Cairo Geniza, vol. 2, pp. 240-272. Berkeley and Los Angeles, 1971. Fundamental study based on medieval documents found in a Cairo synagoque. Leiser, Gary. “Medical Education in Islamic Lands from the Seventh to the Fourteenth Century.” Journal of the History of Medicine 38 (1983) 48-75.

Morsy, Soheir A. Gender, Sickness, and Healing in Rural Egypt. Boulder, 1993. Important for its analysis of the interplay of medical perspectives.

Rahman, Fazlur. Health and Medicine in the Islamic Tradition: Change and Identity. New York, 1987. Learned Islamic perspective. Rispler-Chaim, Vardit. Islamic Medical Ethics in the Twentieth Century. Leiden, 1993. Analysis of fatwas (largely Egyptian) on medical ethical issues.

Rosenthal, Franz. Science and Medicine in Islam. Aldershot, 1990. Collected studies by a leading historian of Islamic society, culture, and science.

Temkin, Owsei. Galenism: Rise and Decline of a Medical Philosophy. Ithaca, N.Y., and London, 1973. Masterful account of Galenism in both the Islamic world and Europe.

Ullmann, Manfred. Islamic Medicine. Edinburgh, 1978. Series of eight studies, valuable but traditional in their bias toward “real” medicine.

LAWRENCE I. CONRAD

Contemporary Practice

Medicine in modern Islamic societies must be understood in the context of Western political, economic, and scientific dominance. In the nineteenth century many Muslim rulers, convinced of European military and scientific superiority and anxious to defend and strengthen themselves and their societies, began to establish Western-style medical facilities. In 1822 Muhammad `All, the ruler of Egypt, invited Antoine-Barthelemy Clot, a French physician, to organize his medical services. In 1827 Clot founded a hospital and medical school in Cairo where European medicine was taught. In 1839 the Ottoman sultan Mahmud II opened a Western-style medical school in Istanbul. Muslim rulers from Morocco to Indonesia recruited European physicians to serve them and often to organize their health services.

In the era of direct colonial rule, beginning for example in Algeria in 183o and in Egypt in 1882, the French and British authorities administered medical services and usually placed their nationals in the highest positions. Medicine was not a priority for colonial administrators, who generally established modern hospitals and public health facilities only in the European quarters of larger cities. In Algeria and Egypt medical facilities came to reflect the class structure of the colonial societies, with the best hospitals for the French or British, second-class hospitals for Jewish or Italian communities, and third-class hospitals for the Muslims. The vast majority, in both urban and rural areas, did not have recourse to modern medicine and continued to consult herbalists, bonesetters, health barbers, midwives, spiritual healers, and other practitioners.

After political independence was won in the first part of the twentieth century, most Muslim governments began to require physicians to be trained and certified by Western-style medical schools, although some gave traditional practitioners a second-class medical status. Nationalist governments frequently made the extension of medical services an important political platform, and medical schools, hospitals, and other medical facilities and public health systems were expanded throughout the Muslim world. In Egypt, for example, the Department of Public Health was made into the Ministry of Health in 1936, and in the 1940s resources were increased in response to the recurrence of deadly epidemics. A system of rural and urban health units instituted in the 1940s was enlarged under the regime of President Gamal Abdel Nasser, and Egypt today has a vast network of medical services. Nevertheless, inequities and organizational difficulties have resulted in widespread deficiencies. Oil-rich nations such as Saudi Arabia have spent billions on importing ultramodern medical facilities; poorer nations like Pakistan, which spends less than 1 percent of its gross national product on health, have inadequate medical facilities. In many regions medical schools have produced more specialists than needed while the basic needs of the rural and urban populace go unmet. Programs to train physicians, public health nurses, and other personnel to practice preventive medicine in rural and urban health centers are, however, becoming more common.

As elsewhere in the world, modern medical technologies have not brought unmixed blessings. As a result of improved public health and medical services and the increased production of foodstuffs, populations have soared, outstripping resources. In some regions modern irrigation techniques now allow for the cultivation of two or three crops per year, but waterborne bilharzia (schistosomiasis) has spread into previously uninfected regions. Automobile and industrial pollution now chokes major cities of the Muslim world, resulting in a widespread deterioration of public health. The medical inequities of the preindependence era have continued and even become worse in many regions.

In recent years, however, many Islamic reformers have become disillusioned with modern medicine, claiming that its tendency to treat the patient symptom by symptom rather than as a whole person is inherently dehumanizing and medically unsound. Modern medicine, they argue, has become overly materialistic and technocratic, addressed to the financial interests of the medical industry rather than to the unique needs of the patient. They have called for a return to Islamic values to make modern medicine more humane and moral, based on preventive rather than curative medicine and addressed to the needs of the individual and his or her community. Medical reformers are trying to reinforce the concept of caring for the whole person rather than treating one organ or an isolated ailment, and for using natural remedies, nutritional regimens, and spiritual healing before more radical treatments and surgical intervention.

In 1982 the Second International Conference on Islamic Medicine, held in Kuwait, addressed many of these questions. Specialists in Islamic medicine from many parts of the world called for integrating Islamic medical ethics derived from the Qur’an and sunnah with modern medicine. Some called for Muslim medical students to learn the medical ethics of Islam by studying the shari`ah and hadith and biographies of noted Muslim physicians. Others called for research programs to study the efficacy of the diverse traditional medicines of Islamic societies. The conference ended with recommendations to launch the World Islamic Medicine Organization established after the first conference, to publish Kuwait’s Islamic Code of Medical Ethics, and to further study the role of Islam in medical education. The conference participants repeatedly expressed their discomfort with aspects of modern medicine and a nationalistic pride in the medical achievements of earlier centuries.

In addition to such academic specialists in Islamic medicine, many Islamic religious authorities, commentators, and philosophers have attempted to bring modern medicine into the framework of Islamic ethics. They generally argue that in Muslim societies, no activity of life, including the practice of modern medicine, should be secular. In many cases, the solution is to find sanctions for or prohibitions of modern medical practices within the Qur’an or hadith. For example, in Riyadh, Saudi Arabia, the religious authorities were asked to rule on the legality of organ transplants. In 1982 (6 Dhu al-Qa’dah 1402) the senior `ulama’ issued Decree Number 99, stating that organ donation and transplantation both during and after life are legal provided that written consent is available from the donor or the next of kin. In Egypt, Shaykh Muhammad Mutawalli al-Sha’rawi, the prominent Islamic commentator, has given his views on the ethics of cosmetic surgery. He has reasoned that if it leads to modifications in God’s creation it should be viewed negatively, adding that beauty is a gift of God that is beyond human understanding and should not be measured by humankind. On the other hand, he suggests, if such surgical intervention relieves suffering, including psychological suffering, it would be acceptable under Islamic ethics.

The late Fazlur Rahman, a noted Pakistani philosopher and Islamic reformer, argued that in the Qur’an and hadith, the needs of the living are more important that those of the dead, and therefore both dissection and organ transplants are legal (see Rahman, 1987). Regarding genetic engineering, he reasoned that although tampering with the will of God was not acceptable, the genetic improvement of plants and animals had been accepted since the beginning of history, and so should the genetic improvement of human beings as long as it involved no loss of human life or dignity. He argued that the technology involved in producing test-tube babies helped a husband and wife have children and so should be sanctioned. If, however, the reproductive cells were from donors rather than from the husband and wife, the procedure should be illegal, because under Islamic law adultery means not only extramarital relations but also confusing the genetic heritage of the child. Finally, regarding prolongation of life by artificial means, he reasoned that it was not acceptable because the Qur’an emphasizes the quality of life over the quantity of life. If the quality of life was also improved it was acceptable, but this meant that the environment and food resources must be improved at the same time. Like many but not all Islamic authorities, he argued that family planning is acceptable in Islamic ethics, as is abortion within the first four months of pregnancy. He observed that even when the `ulama’ have objected to medical advances, Muslim communities have often accepted them, providing an additional argument for them on the basis of community consensus. [See Family Planning; Abortion.]

One of the most intractable issues for contemporary medical practice is the worldwide spread of AIDS. Because of the officially prescribed ideals of Muslim sexual behavior, a number of Muslim governments have been reluctant to disseminate information or even to collect statistics on the epidemic, preferring to view it as a foreign danger to be stopped at the borders. Muslim physicians and social critics such as Munawar A. Anees, however, have argued convincingly that there is a gulf between ideals and realities, that the community is responsible for the welfare of all of its members, and that this “denial syndrome” must stop.

In response to the many calls for the integration of modern medicine within an Islamic framework, Islamic hospitals have been established in many cities in the Muslim world. In Amman, Jordan, for example, the Islamic Hospital is large, active, and modern, resembling any Western hospital except for the conservative Islamic dress worn by its employees, male and female physicians and staff members alike, and its insistence on conforming to Islamic values in its practices. Many of the Islamist (fundamentalist) movements have made medicine an important part of their social services, and their clinics and hospitals often dispense free medical and public health services.

In conclusion, many reformers have asked why Islamic civilization has not assimilated and advanced Western medicine as easily as it assimilated Greek, Persian, and Indian medicine in the early centuries of Islam. One common answer is that Islamic civilization was politically dominant over the more scientifically advanced civilizations, in contrast to the present situation, making it psychologically easier to incorporate new knowledge into the cultural framework. Another is that current medical research is far more complex and costly than in earlier centuries and thus more difficult to assimilate. Whatever the answer to this question, implicit in it is another question: how can Muslim societies end their dependency on the West and advance on their own terms? Some believe that the Muslim world must return to its Islamic roots, for example by instituting the Qur’anic zakdt tax (a tithe on income) to fund regional medical research centers where the wealth and talent of the region can be concentrated. Others argue with equal conviction that the solution lies in secular and democratic political, social, and economic reforms that would combine the wealth and talents of the region in a secular atmosphere. This conflict between Islamist and secularist views of medical, public health, and other social reforms is perhaps the most crucial of the present era.

BIBLIOGRAPHY

Anees, Munawar A. “The Silent Killer: AIDS and the Muslim World.” The Minaret (January-February, 1994): 33-35.

Faqih, S. R. al-. “The Influence of Islamic Views on Public Attitudes towards Kidney Transplant Donation in a Saudi Arabian Community.” Public Health 105 (1991): 161-165.

Gallagher, Eugene B., and C. Maureen Searle. “Health Services and the Political Culture of Saudi Arabia.” Social Science and Medicine 21.3 (1985): 251-262.

Gallagher, Nancy E. Medicine and Power in Tunisia, 1780-1900. Cambridge, 1983. Discusses the transition from Galenic-Islamic to Western medicine in Tunisia in the context of European political and economic expansion.

Gallagher, Nancy E. Egypt’s Other Wars: Epidemics and the Politics of Public Health. Syracuse, N.Y., 1990. Shows how malaria, relapsing fever, and cholera became major political issues in the post-World War II era.

Good, Byron. “The Transformation of Health Care in Modern Iranian History.” In Modern Iran: The Dialectics of Continuity and Change, edited by Michael Bonine and Nikki R. Keddie, pp. 59-82. Albany, N.Y., 1981.

Jundi, Ahmad Raja% and Hakeem Mohammad Zahoorul Hasan, eds. Proceedings of the Second International Conference on Islamic Medicine. Kuwait, 1982.

Khan, Muhammad Salim. Islamic Medicine. London, 1986. Argues that the creative thought, balanced lifestyle, and healing forces known to the Islamic medical tradition can reform modern medicine.

Kuhnke, LaVerne. Lives at Risk: Public Health in Nineteenth-Century Egypt. Berkeley, 1990. Discusses epidemics of cholera, plague, and smallpox and Western medical institutions introduced by Muhammad `All.

Morsy, Soheir A. “Towards a Political Economy of Health: A Critical Note on the Medical Anthropology of the Middle East.” Social Science and Medicine 15B (1981): 159-163. Provides background to the study of traditional medicine.

Nanji, Azim A. “Medical Ethics and the Islamic Tradition.” Journal of Medicine and Philosophy 13 (1988): 257-275.

Rahman, Fazlur. Health and Medicine in the Islamic Tradition. New York, 1987. Indispensable study of Islamic ethics, medicine, and health, beginning with a comprehensive analysis of “Wellness and Illness in the Islamic World View.”

Rispler-Chaim, Vardit. “Islamic Medical Ethics in the Twentieth Century.” Journal of Medical Ethics 15 (1989): 203-208.

Sonbol, Amira. The Creation of a Medical Profession in Egypt, 1800-1922. Syracuse, N.Y., 1992. Surveys the introduction of Western medical institutions into Egypt.

NANCY E. GALLAGHER

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