Adab al-Ṭabīb: Chapter Eight

On What Both the Healthy and the Sick Should Believe and Hold in Their Hearts About the Physician in Times of Health and Sickness

By Isḥāq ibn ‘Alī al-Ruhāwī (d.~931 CE)

Human bodies are constantly in flux and change, because they are composed of opposing elements that compete with one another, and because they are naturally receptive to the effects of higher [external] forces. For this reason, they need correction when excess or deficiency occurs, and each strong quality must be countered with its opposite. By this balance, every constitution reaches the particular moderation it requires, and each body can perform its proper, healthy functions. Correcting this balance, together with repairing what is damaged in the structure of the organs, restoring what has been lost in large measure, or adjusting what has shifted in form or position from its natural state, is the greatest foundation of medicine. The one who knows this and what follows from it is the [actual] physician.

Healthy bodies must also be preserved in their state of health. That preservation cannot be achieved except through what is similar to them. Nothing can resemble the body except by knowing its temperament, the proportions of its humors, the unique pattern of its balance, and what belongs to each organ in terms of temperament, form, structure, connection, and position. One must also know the proper ratios and measures by which a body’s likeness is maintained.[1] This entire body of knowledge, with all its branches, makes up the science of medicine. The one who possesses this knowledge is the physician. It is through this that he can preserve health and restore it when it is lost. It follows, then, that both the healthy and the sick are in need of the physician in times of health and in times of sickness.

A person’s very self is his most precious possession. The most precious quality he possesses in himself is health. Health cannot endure or be preserved except by the art of medicine. For this reason, the wise and virtuous who value the well-being of their souls have always held in the highest regard the one who possesses this art, ranking him above others in station, honor, and trustworthiness.

I am not referring to those who bear the name of medicine while lacking its reality. Such people are more deserving of contempt than honor, for they delight in lies and are content with falsehood. Rather, I mean that honor is due to those who recognize the magnitude of what Allah has granted them in this great gift and high station: namely, His granting humanity the knowledge of medicine as a form of divine care and mercy. Since not all people are suited to learn it, Allah singled out a few among them—those with clear minds, sharp understanding, love of good, loyalty to their fellow humans, compassion, and restraint. Whoever Allah has chosen for this blessing must continually thank Him, worship Him sincerely, and devote true love to Him.

Without doubt, the best among people consider it their duty to honor this class of physicians. Whoever belittles them, denies their rights, or lowers their station has denied the blessings of Allah, rejected His favor, and treated His generosity with contempt. Every rational person knows that whoever behaves this way only debases himself and exposes his ignorance. Among the clearest proofs of this ignorance is what we see when a person falls ill: he turns away from father and child alike and no longer places hope in a friend or close companion. Instead, he cries out to Allah for help through the physician. Yet once cured, he mistreats the physician and neglects his rights. Such behavior cannot be counted as rational. It is more fitting to compare it to that of animals.

Many people have even come to hate physicians and avoid their company, not to mention refusing to love or honor them, simply because physicians restrict their desires and warn them against indulging their pleasures. They resent the physician’s presence, curse him, and instead praise those who indulge their cravings, flatter them, visit them often, and serve them in whatever they wish to hear and enjoy. Knowing this, deceitful physicians use these tricks to win over the wealthy and powerful. Their schemes are like the hunter’s net.

If this is the reality, and testing it is easy for anyone who looks closely, then one must recognize the traps, snares, and devices set before them—by which I mean the outward display of appearances, the lofty seats they occupy, and the fine instruments and decorations they fill their shops with. A wise person should not be deceived by such artifices. He should examine instead what the physician truly excels in, what rank he holds in the art of medicine, how he has spent his life, and what his conduct has been. In short, he should test the physician by all that I will set out in the chapter on examining physicians. If he finds him truly of the medical art, then let him believe that such a person is among the friends (awliyā’) of Allah[2], honored by Him, to whom He granted this science, singled out with the privilege of guiding others of his kind, reforming their souls, correcting their morals, regulating their bodies, and preserving their health. This is the true physician, which is to say, the philosopher[3].

When a rational person believes that the virtuous physician is among the chosen servants of the Creator—blessed and exalted—then he is obliged to honor him outwardly, love him inwardly, share his blessings with him, and hasten to fulfill his needs. By securing the physician’s well-being, his mind is cleared, his thoughts are sound, he devotes himself to medical study, and he remains constant in serving you in both health and sickness. For you, O rational one, are always in need of preserving your health, since the causes that change it are constantly affecting you. You are also never safe from the onset of disease. You will always need someone to guide you in how to preserve your health, by what means to preserve it, how to manage your illness, and by what remedies to treat it.

It is therefore necessary for you to make the best physician in your city your physician. You must accept his commands as binding upon yourself, treat him with the respect you owe a friend, learn from him as a student learns from his teacher, and preserve from him the knowledge of medicine and the benefits it brings you. In this way, he holds over you the right of a teacher, a bond greater than that of kinship or friendship—the bond of knowledge and discipline, by which a human being becomes truly human.

Know that just as the wise householder prepares food, clothing, and shelter for himself and his family before the coming of winter, and just as the sailor prepares his vessel before the arrival of winds and storms, so too you must prepare for yourself a physician suited to you. Keep him close by good conduct, good company, and generosity, so that he may be your provision for times harder and more dangerous than storms at sea or the hardships of winter. What has been said here is sufficient for those of sound mind.

---

[1] This reflects the pathophysiology of medicine at the time. In each era, this paragraph would be rewritten with its contemporary understanding. The author’s point is that a physician should be well-versed in pathophysiology.

[2] Understand well that he is not a friend (walī) by virtue of simply being a physician, but by his decorum before Allah as a physician. Allah states, “Its (competent) custodians (awliyā’) are none but the Allah-fearing, but most of them do not know.” (8:34)

[3] The philosopher is the one who perfects the underlying sciences: the appropriate (Islamic) metaphysics, the sanctioned and unsanctioned practices (fiqh), and perfection of character (ihsān).