11.4.1 CONCEPTS OF DISEASE

Disease is divergence from the normal, gaussian mean, but not all deviation is disease because of the reserve capacity and ability of the body to adjust to variations. The demarcation between pathology and normal physiological variation can be fine. The definition of disease is very relative being affected by age, gender, culture, beliefs, socio-economic status, attitudes, and prevalence of diseases. Definition of disease considers several dimensions that may operate singly or in combination: moral or spiritual, biological or pathological, psychosocial, or normative statistical. Overall disease is a state of dis-equilibrium, khuruuj al badan ‘an al i’itidaal. A distinction must be made between disease as a pathological manifestation and illness that is a subjective feeling. Symptomatology is perhaps a better indication of disease severity because it includes the personality of the patient and reactions. Thus the same pathology does not produce the same symptomatology in all patients. Those with strong iman may complain less about pain than others. Prognosis is an empirical estimate of the future course of the disease based on available data and is not definitive because the final outcome is part of the knowledge of the unseen, ‘ilm al ghaib. The physician does not have the privilege to say anything definitive about the future prognosis. There is a 2-way interaction between diseases of the heart, amradh al qalb, and diseases of the body, amradh al badan. The Islamic position is to approach most diseases empirically and to be guided by experimental science. Islam rejects superstitious beliefs and practices in all their various forms and manifestations.

11.4.2 BASIS OF CLASSIFICATION OF DISEASE

Diseases may be classified by their duration as acute or chronic, by cause as diseases of the heart, amradh al qalb, (2:10 & 74:31) and diseases of the body, amradh al badan, by life-stage as congenital or acquired, by nature as mental or organic, as local or systematic, and by organs afflicted. The physical environmental causes of disease are: infection, physical energy, degeneration, and breakdown of homeostatic control. Most disease processes are actually attempts by the body to repair damage. Some diseases are gender-specific because of the organ that is affected.

11.4.3 NATURE OF DISEASE

Disease is a pathophysiological disturbance is normally a response to a biological, physical, or chemical insult or injury to the body. Thus most disease manifestations including their symptoms and signs are a reaction to the injury and an attempt to re-adjust. In an Islamic context, disease does not always connote a negative or bad event. There are indeed many situations when what is a disease situation is actually beneficial. It forces us to rest, its pain teaches patience and forbearance, it is an opportunity for expiation/atonement for previous sins, al maradh kaffaarat ‘an ba’adhi al dhunuubi (MB1949). The trials that one goes through and the eventual patience can be rewarded by Allah’s forgiveness (MB1948, MB1951). Some diseases are due to disobedience. Acts of disobedience may be followed by epidemic disease or by disease in an individual. The disease may be directly related to the sin such as liver cirrhosis due to chronic alcohol consumption or there may be no direct relationship. The prophet taught that when communities commit inequities, Allah sends them diseases unknown in their ancestors. Many of the diseases of industrialized societies are related to lifestyle and may be Allah’s punishment for various transgressions. Allah in recognition of the burden of disease and the need to give the body a chance to recuperate excused the sick from some physical religious obligations (2:10 & 73:20).

11.4.4 CAUSES OF DISEASE