Edited by Dr. Shahid Athar
The JIMA believes not only in the revivalism and fine establishment of the tenets of the Islamic faith within the individual and within Muslim society but also in restoration, review, research and compilation of the knowledge of the brilliant past of Islamic Medicine. We have proposed to several Islamic countries to open a department of Islamic Medicine in their medical schools as well as to establish an Institute of Islamic Medicine for gathering extent works of great Hakims of the past, to translate them, to do clinical and laboratory research on their empirical findings and their vast Pharmacopoeia.
To this end, we have obtained permission first to publish in parts the translation by Martin Levey of Adab al-Tabib of Al-Ruhawi’s “Practical ethics of the physicians” which was printed by the American Philosophical Society as the Transactions of APS, vol. 57, part 3, 1967, Philadelphia.
Who was Ruhawi?
Ishaq Ibn Ali Al-Ruhawi must have written his deontological treatise, Adab al-Tabib in the 9th century. After al-Rubawi, to complete the picture, one should mention two of the greatest physician-philosophers of the Islamic World, al-Farabi (d. 950 A.D.) AND IBN SINA (B. 980 A.D.). Al- Ruhawi was probably from Ruha, a city of northwest Iraq. Earlier, it had been called Edessa, a well known center of Nestorian learning at one time. He was a Christian who embraced Islam and had written two works on Galen.
Al-Ruhawi’s Adab al-Tabib is found as a unique copy in the Suleymaniye Kitabhane #1658. It comprises 112 folios, seventeen lines per page and is written in a good Nashki hand. The dedication is to the Sultan Bayezid.
In previous publications the first chapter and part of chapter 11 of Ruhawi’s Adab Al-Tabib were presented. JIMA will continue to publish pertinent sections and chapters of this great work of the second IsIamic Century . (9th century A.D.).
Statement on Edible Matter
(Ruhawi’s Adab al-Tabib translated by Martin Levey)
Since what we have mentioned in regard to the five senses is useful for systematic improvement, a word is in order on the natural matters as an example and for guidance,. We mentioned the natural matters of air, exercise, and rest. It is necessary to follow up with a statement on edible matter, by the way, with brevity and with mention of useful factors which will encourage and urge one to study science in its occurrences and its books.
I say that edible matter may be called food as a synonym since food is sometimes made of it. Real foods are substances which are distinguished from edible matter by the first, second, and third cooking, and their superfluities, which are not eaten, are thrown away. Those substances remain which are suited to become a part of the one who eats [them], and takes the place of what was lost by him since they make a quantitative excess. In this way, he is not dissolved away and does not perish.
The situation is such that you will find that edible things have different tastes and qualities, and accordingly affect the body in various ways. Thus, it is necessary to know their composition and functions. I mean also that one should also understand the body and its natural complexion; together with this it is indispensable for you to know the natural or acquired complexion of its stomach.
Our excellent teacher Galen encourages and leads us to this in his book On Nutrition. He said, “It is necessary that one be careful to know these matters. You find that foods sometimes are slow to swell up and sometimes quick. This depends on the reaction of the stomach at the beginning or by the substances in that which was eaten and drunk. Because some of them are moist, some dry, some viscous, some quickly separating and falling apart, some pungent and acrid, some sour or bitter or sweet or salty, and sometimes these properties are found in drugs, therefore properties of foods are considered as easy remedies.”‘ It is essential that the physician take Galen completely at his word to the full extent of this science for the preservation of life is of great importance.
Galen said that the science of the properties of foods is close to being one of the most useful of medical sciences. While there is not always need to employ the other [sciences] for bodily health, the need for food is always present, both in times of health and illness, for life does not go on without it.
It is not necessary, 0 physician, that you imitate any writer in regard to the properties of foods, their states, and their functions in the body. Some have written volumes on the basis of experience but this experience is insufficient when applied to an actual case. You may, however, find some similar factors which are common but it is not sound to judge by these merely. An example of this is that you find several things which cause diuresis or facilitate an abundant flow, and so on. You find that some are cold and some hot. In teaching this, Galen quoted the scholar and physician before him called Theophilus. It is this, Galen said that Theophilus stated that men are not wise who believe that a single property like taste or heat or smell when found in two things will make them all alike. Aside from this common factor, there may be many different properties. One must not, therefore, treat all substances which empty the belly, or cause diuresis, or have any other common property, as being alike in all their properties. This is so because that (substance] may be hot or cold or salty and not every sweet or salty thing has the same strength in taste. But one may consider that the resultant action of a substance comes from its total make-up. Whoever grasps this principle will make no mistake and will not lose the truth.
It is not convenient for you to hold back anything of a food or drug because of its effect on one sense, and so believing that it possesses only this effect. Sometimes you find that what seems very apparent is one thing but its actual effect is another. Examples are the lentil and cabbage which act oppositely [to their effect on the sense of smell]. They empty some bellies and fill others; they do this since in their creation they are made up of two different substances having two different properties in composition and complexion.
Galen said, “As to the reason why the lentil’ empties and softens the belly of some people, and does not restrict and block it, I add that I explained this in the book On Simple Drugs. It is that many kinds [of drugs] which are considered to be simple and single are compounded, at the beginning of their creation, of different substances with opposite properties instead of what we compound with our skill. In them, there are different activities. You find these in many foods like the lentil, cabbage, and all sea animals which have a skin with a sharp taste; each one of them is composed [of substances] with opposite properties. Thus, their body is hard and slow to swell, the belly is under control and may be emptied. The explanation for this is what when they are cooked, their soup empties the belly but its hard body keeps the belly under control. People, however, disagree about this.
When considering foods, the conditions in the stomach [should be recognized]. You may find that a flame heat dominates it. This may be so because of the complexion brought about in creation or yellow bile which pours into it because it has been deviated from its source on its way to the intestines. In this case the stomach digests some foods which are thick like beef, etc., and the thin ones like the meat of chicken and partridge spoil in it. It is not necessary to examine and experiment with the foods to prohibit some since some are quickly land some are slowly digested, according to the conditions in the stomach. Since this stomach condition is far from normal, it is not correct to make a judgment on the foods in it.
It is necessary to examine once more the question of foods. Some edibles which are in abundance resemble body matter. These are wheat, barley, rice, and similar grains; also there are palatable foods as animal meats which may be quickly cooked and digested. All of these and what is similar to them feed man when they are well prepared; they are good nutritionally.
As to the edibles which do not resemble the body of the eater, when they are together with non-nutritional matter [they] may make one ill if he does not know how to use them. These edibles have excessive sourness, are excessively salty, excessively sweet, and an excessively styptic acridity may predominate. These are more like drugs. Between the extremes of these edibles and their opposites, there are many which, when well prepared, will nourish the eater and not injure him.
There are also those which, because of moderation in taste, are often employed to improve bodies. It improves the health of old people, especially those whose complexion is cold, in whom phlegm predominates, in periods of cold and in cold countries. Understand this, and compare with it the rest of the edibles which have obvious and different tastes. When you recognize good food, then beware of an excess or deficiency but favor moderation. This is better.
Hippocrates had a saying that every excess is an enemy of nature, and a deficiency is lacking in trustworthiness. When one exceeds the natural amount, Hippocrates stated that there is no bearing or appetite or any other favourable thing. Hippocrates also said that when excessive food is ingested, it is superfluous and causes illness with its coldness.’ He stated that it is important that one predetermine the amount of food for the body with regard to the state of the season in which one is. There are two seasons, summer and autumn, when the body cannot endure excessive food. In regard to the seasons of winter and spring, it may take much food. Hippocrates pointed this out in a statement when he declared that the most difficult period for the body to take care of food is in summer and autumn; the easiest time is in winter and spring. Galen explained and commented upon this by saying that bodies begin to be cold in the autumn, to come together to be thick, and then in winter to loosen and to be light. Galen said also that in winter and spring, the belly is hottest and sleep is longer, Because of these two reasons, more food is necessary since more natural bodily heat is required then. Thus, more food is essential. Evidence of this comes from the aged.
It is also indispensable to know the time of the meal and the small snacks. I mean that it is necessary to eat during the day and night, and [it is necessary] to know the time between meals. The eater must know this and also the speed of his digestion, and also how long it takes his stomach to be emptied of the last meal and of spoiled mixtures and excesses. Hippocrates summed this up when he stated in On Epidemics, in the sixth discourse, when he arranged for the food after exercise and before sleep. He said, “Weariness, food, sleep, and coition must be aU organized by a natural arrangement.” He meant that one must predetermine intentionally the quantity of exertion of each one by the eater. Hippocrates said that the body which is not clean, whenever it ingests food, makes its advances in evil
In some edibles like vegetables, there is very little nutriment; in some there is much as in animal meats and hard grains. Some are in between these like the meat of lamb, chicken, partridge, the yolk of eggs, etc. For this reason, it is necessary to know the science of this to use what is valuable according to the need. [Another reason] is that the spoilation of some edibles is rapid since they change so quickly; some are slow to spoil since they are resistant.
Thus, it is incumbent upon the physician to know the arrangements of food according to this and according to the condition of the stomach. It is often convenient to present the quickly changing foods first before those which ripen slowly in order to facilitate the penetration of a hard one so that it not be spoiled were it to precede the quick one. To eat melon, apricot, and others first before bread and other edibles is better. For this reason, one must be careful what he cats after the meal so as not to spoil the food, mixtures, and the stomach. Do not neglect, in view of what i have presented, to take account of age, heat, the countries, habits, occupations, and conditions since the science of an these is necessarily indispensable for everyone who wishes to nourish his body properly. Carry on by these and compare them.