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Qur’anic (Dynamic) Paradigm of Health -3 – Fundamental Duties in Islam: Impact on Health

Qur’anic (Dynamic) Paradigm of Health -3
Fundamental Duties in Islam: Impact on Health
Dr Javed Jamil

Islamic system is neither one-dimensional nor two-dimensional; it is three-dimensional giving equal importance to Fundamental Rights, Fundamental Duties and Fundamental Prohibitions. This citadel of Peace has Duties as the Foundation, Rights as the Roof and Prohibitions as Walls. The modern systems, on the other hand, stress only Rights, undermine Duties and ignore Prohibitions altogether. Before embarking upon the development of Qur’anic paradigm of health in detail, let us first discuss the medical implications of some of the Fundamental duties in Islam. This is necessary to facilitate discussion on the foundations of the paradigm.
Iman (Faith), Salat (Prayer), Saum (Fasting), Zakah (Charity) and Hajj (Pilgrimage) are regarded as the five pillars of Islam. There are other Islamic duties as well like gaining knowledge (Ilm), striving in the cause of God (Jihad), inviting others to Islam (Dawah), promoting Good (Amr bil maruf) and campaigning against Forbidden (nahi anil munkar). We will discuss the impact of Faith on health at a later stage when we will discuss Spiritual Health. We will first concentrate on Salat (prayer).


Islamic prayer (Salat) is preceded by Wudu (Ablution), a process by which the organs of the body are washed and rubbed (with a moistened hand) in a certain fashion. Qur’an says:

“O believers! When you prepare for prayer, wash your faces and your hands to the elbows; and rub your heads and your feet to the ankles. If you are in a state of ceremonial impurity, bathe your whole body. But if you are ill, or on a journey, or one of you comes from offices of nature, or you have been in contact with women, and you find no water, then take for yourselves clean sand or earth, and rub therewith your faces and hands, God does not wish to place you in a difficulty, but to make you clean, and to complete his favour to you, so that you may be grateful.” (Chapter 5, Verse 6)1

Qur’an only describes the general order. We are made aware of the details in the traditions of Prophet Muhammad (PBUH). A very specific order of washing the organs is followed. First, (after washing the hands to ensure that no dirt goes along with the water) mouth is cleansed, taking water inside mouth and rinsing three times. Then some water is pushed into nostrils. After this the whole face is washed with both hands from the forehead to the chin. This is followed by washing of hands, from hand to elbow (hands, forearm and elbow). All these actions are preferably repeated thrice. After washing hands and forearm, one again returns to head, passing a moistened hand over the head (also behind ears and neck in Sunni school of thought)). Lastly, feet are either washed (Sunni school of thought) or rubbed with moist hands (Shiite school of thought)) three times.

This sequence is extremely significant. There are different regions in the brain, which have a map of the body on it. The body in this map appears to be highly distorted form of the body that our eyes see. Each area of the body is represented on a specific place in the brain. Sensory map is situated on a portion of the brain called postcentral gyrus. (See the anatomical diagram of the sensory area on the postcentral gyrus.)1

Brain is the organ of the body that controls various functions of the body. Apart from performing functions such as thinking, learning etc, it receives different types of sensations such as cold, touch and warmth. It analyses them so that the body can be able to give a proper response to each one of them. Brain consists of several parts such as cerebellum, cerebrum, thalamus, medulla oblongata, pons etc. The brain substance consists of grey and white matters. Cerebral hemisphere is the seat of higher functions. It is also the final centre for the reception of all types of sensations and consists of frontal, parietal, occipital and temporal lobes. It has been found that the cerebrum has a peculiar cortical organisation. A specific bit of the substance of the brain receives sensations from a specific portion of the body. Using various techniques including electrical stimulation, the projection of the body surface has been mapped on the postcentral gyrus2, a portion of Cerebrum, and it has been seen that the projection is in the following order (from below upwards) (Note that the images are reverse in the brain.):

Figure 1  Representation of body parts in Brain
– Intrabdominal
– Throat and inside of mouth
– Tongue
– Teeth, gums and jaw
– Lower lips, lips and upper lip
– Nasal passage
– Nose
– Eye
– Forehead
– Cheek, ear, chin,
– Thumb, and other fingers
– Hands
– Wrist
– Forearm
– Elbow
– Arm
– Shoulder
– Head
– Neck
– Trunk
– Hip
– Leg, toes and foot

The Scientists are of the opinion that this extensive coding system has a lot to do with the various sensations of the body. Loss or diminution of the function may cause degeneration of the part of the brain associated with that function, and vice versa. Some bands known as psychic bands surround the sensory, visual and auditory areas. Their lesions cause the inability to perceive the objects, so they are said to combine the sensory impression into significant patterns.

Figure 2 Mini Man inside brain
The researches on that map have now grown substantially. Now a term “Homunculus” 3 is being used to describe that map, and has become a topic of huge interest. Homunculus means a tiny and highly disfigured man within man, which controls him. (See the diagram3. It represents the mini-man on the map at postcentral gyrus corresponding to the relative sensitivity of different organs.) It can be seen that organs washed or rubbed in Wudu cover almost 80% of the total surface of the image in the brain.) It is important to note that

  1. The mapping is not in the order like head, face, trunk, hands, foot etc, but according to the spinal enervation. So is the order in the Wudu.
  2. Mouth is rinsed first and the face is washed later. This is exactly the sequence the homunculus shows.
  3. Again, instead of rubbing head along with the face, hands and forearms are washed first and then head is rubbed. This again is according to the sequence shown in the map.
  4. In Wudu, first, hands are washed followed by wrist, forearm and elbow. Homunculus again depicts the same sequence, not from elbow to hand.
  5. It is also highly significant that Homunculus, the mini man on the map, is a highly distorted image of man5-6. This is because the representation of different organs on the map is not in accordance with what the human image is but in accordance with the sensitiveness of different organs in the brain7. Thus the mini-man has massive lips and very big hands, face and feet. The portion from the neck to the legs occupies hardly 15-18 per cent of the mini-man. This means that by washing only certain portions in the Wudu, one activates almost the 80 percent of the mini-man inside the brain.
  6. There are very specific cortical paths8, which also explain why the face is washed simultaneously with both hands while other left and right extremities are washed one after another. This is because both the parts of the face, right and left, are represented in both portions of the brains. In contrast, extremities are only represented on the opposite side.
  7. The head and feet are extremely sensitive superficially, so mere rubbing of them would also serve the purpose of activating the brain.
  8. The homunculus plays an extremely significant role in temperature control mechanism of the body. In the events of the infarction of this area of the brain, there are huge temperature regulation failures on the corresponding sides of the body.
  9. The cortical area covered by the hands is one of the largest. If the more sensitive areas are stimulated first, they can immediately call the body to bring out proper responses. For example if the hands are put into cold water, the blood vessels may constrict resulting in decreased loss of heat from the body. Though in Wudu the first portion to be washed is mouth, hands are washed before that to ensure that the water does not become dirty. In doing so, the brain also gets acclimatised to the warmth of the water.
  10. As is seen in the picture of mini-man as mapped in the brain, hands and face occupy the largest portions and cover more than 70% of the total area. By rubbing these portions therefore, as in Tayammum, too, a very significant portion of the brain is activated. (In Tayammum, which is done in absence of water, hands and face are rubbed with sand or soil.)
  11. In Wudu, only those parts are washed or rubbed, which are normally exposed to atmosphere and are easy to wash. In ghusl (bathing), the whole body is washed, and Islamic ghusl again follows the pattern in the homunculus.

Medical benefits of Wudu

We have just seen how almost 80% of Homunculus, the mini-man controlling the man from inside the brain gets activated as the result of Wudu. It appears likely that this may substantially increase the ability of the brain to respond to the different kinds of sensory stimuli, particularly heat and cold. As several kinds of psychic bands are also situated along with these sensory areas, the Wudu also increases the capacity to face different psychological situations. Wudu is extremely beneficial in many other ways.

1.         It helps in countering the skin cancers. Approximately 130,000 malignant melanomas occur globally each year, substantially contributing to mortality rates in fair-skinned populations. There are 66000 deaths from malignant melanoma and skin cancers every year9. In Norway and Sweden, the annual incidence rate for melanoma is estimated to have more than tripled in the last 45 years; in the United States, the rate has doubled in the last 30 years. Worldwide, the incidence of melanoma varies more than 150-fold. The highest rates are found mainly in those nations where people are fairest-skinned and where the sun tanning culture is strongest: Australia, New Zealand, North America and Northern Europe. One in three cancers worldwide is skin-related; in the United States, that figure is one in two. There are an estimated 1.1 million annual cases of skin cancer in the United States. The melanoma cancers particularly affect the white people, while non-melanoma cancers affect both whites and blacks. It is now well known that

(a) continuous exposure to sun light is the chief factor in melanoma cancers; and
(b) the exposure to industrial pigments like petroleum products and tannin, etc, along with sweat further accentuates the risk of skin cancer on exposure to sun.

If there is a gap of shelter away from the sun for a certain period of time, the chances of Skin cancers would remarkably decrease. If exposed organs are recurrently washed or wiped, this would wash away the harmful chemicals that gather on the skin. This will substantially reduce the risks of skin cancers. Prayer preceded by Wudu achieves both these objectives. There are two breaks for the prayer in the most harmful period of the day. The first, known as Zuhr, is immediately after the midday. This prayer (including the obligatory and additional parts) is the second longest among all prayers. The Wudu involving washing of face and arm and the wiping of head and feet (washing among Sunnis) will ensure removal of dust, sweat and chemicals from the exposed portions. The Wudu followed by a long prayer under a shelter will ensure a shadow for the skin. There is very little to doubt that the incidence of skin cancer will remain low among those Muslims who regularly offer prayers at the prescribed times.

2.         The recurrent washing of the skin and the removal of sweat, dust and other chemicals will also decrease the incidence of infective and allergic disorders of the skin. These include furuncles, pyomas, deep-seated abscesses, rashes, allergic dermatitis, etc.

3.         Oral Hygiene is another important outcome of the Wudu. The rinsing of the mouth and the brushing of teeth (Miswak) are sure to cause a substantial decrease in all the diseases of the mouth, teeth and gums. The Prophet said: “If I had not thought this to be an unbearable hardship for my followers I would have prescribed the use of Miswak before every prayer.” (Bukhari, Muslim)”. It was narrated by the Lady Aisha (RA) that the Prophet (SA) said; “Miswak is purification of mouth and gratification to the Lord.”

On the basis of the worldwide medical studies, it can be noted that

  • According to the epidemiological estimates, more than half of all adults have at least the early stages of the gum diseases.
  • It has also been shown that more than 90% of all people develop gum disease at some part of their lives.
  • The risk becomes greater in Diabetics, drug addicts and alcoholics.
  • The disease of gums and teeth are now known to have caused systemic disorders like atherosclerosis, Subacute Bacterial Endocarditis and Glomerulonephritis10.

When a person eats an item of food and does not rinse his mouth immediately, the food stuck in between the teeth and gums becomes a favourable culture medium for the germs to grow. These germs start affecting the gum first. It begins with a plaque, which is a sticky film of food, saliva and germs. If this plaque is not regularly removed through brushing and rinsing, they settle in the gum lines making them tender and swollen. Later, the plaque starts hardening into tartar. If plaques and tartars are not removed, gums start bleeding even with a gentle touch. This stage is called Gingivitis. Its severer form is called Peridontitis. At this stage, gums begin to pull away from teeth. The pus starts collecting in the pockets. It may then affect the teeth and the bones around it. This ultimately leads to several diseases including what is commonly known as Pyorrhoea. Other infective diseases of teeth are common outcomes with the decaying of teeth. Sometimes the abscesses become deep seated requiring surgical interventions. The more the food particles are allowed to stay the more the likelihood of the infections. If the mouth is rinsed regularly, the chances of infection definitely decrease. Wudu five times a day at regular intervals will surely cause a marked reduction in the probability of the infection developing. And if this is associated with the brushing of teeth, either by the traditional Miswak or its modern counterparts of toothbrush and toothpaste, proper mouth hygiene will be maintained at the desired level to a large extent11.

Recent evidences prove that the oral cavity infections can cause severe systematic diseases, which often threaten life. Periodontal disease permits organisms to enter deep systemic tissues, such as the carotid atheroma. Genco (2002) has shown an association between periodontal pathogens, such as Porphyromonas gingivalis, and atherosclerosis because of the pathogen’s possible direct effect on atheroma formation. P gingivalis has also been found in carotid and coronary atheromas. It may also invade and proliferate within heart and coronary artery endothelial cells, and may also induce platelet aggregation associated with thrombus formation. Oral microorganisms may also enter the deeper tissue after trauma or surgery, and may even cause Bacterial Endocarditis. According to Herzberg, (1983), the bacteria like S sanguis and P gingivalis, found in dental plaque may induce platelet activation and aggregation through the expression of collagen like platelet aggregation–associated proteins, playing a role in the formation of atheroma and thrombosis. Atherosclerosis may lead to heart attacks and cerebrovascular accidents causing Paralysis.


Miswak has rightly been described as Natural Toothbrush, which is in use by Muslims for centuries as an effective method of maintaining oral and dental hygiene. A Miswak is typically made of the twigs of a tree with botanical name as Salvodora persica. But other trees are also used including arak tree, peelo tree, olive and walnut. It strengthens teeth and gums, removes bad odour and protects teeth and gums against infections. A study by Al-Otaibi M, Al-Harthy M, Soder B, Gustafsson A, Angmar-Mansson B (2003) concluded that Miswak was a better protector of oral hygiene than the ordinary toothbrushes. The World Health Organisation too recommended the use of Miswak in its consensus reports published in 1986 and 2000. Plants contain phytochemicals such as alkaloids, tannins, essential oils and flavonoids, which have pronounced antimicrobial activity. A study by Almas, K. (Aug 2002) concluded that that Salvadora persica extract is somewhat comparable to other oral disinfectants and anti-plaque agents like Triclosan and Chlorhexidine gluconate. (Various sources)

Wudu has also a very direct relationship with the practice of Istanja, a process in which genitals are washed after urinating. If the drops of urine remain on the body, it signals an impurity, which must be removed as a precondition for the Wudu. Istanja should be performed after each act of micturition, but if one could not do it due to some reason, one must wash the area before starting the Wudu. Unfortunately, I could not find any statistics related to the beneficial effects of Istanja. These can be taken to show the beneficial effects, as a foregone conclusion. I am planning to start these studies soon. I hope it can be easily proved that there is a direct link between Istanja habits and the urinary tract Infections. The urinary tract infections are one of the three common infections along with Respiratory Tract Infections and Gastrointestinal Tract Infections. These infections may lead to severe burning in urination, difficulty in urination and fever, ultimately leading to the swelling and damage to kidney. Sexual intercourse is one of the common routes of these infections and the chances of transfer of bacteria increase if both or one of the partners do not perform Istanja. Washing immediately before and after intercourse is also helpful in preventing urinary and sex related diseases, but regular Istanja by both men and women can be proved to be a much more effective way.

Dr Javed Jamil is India based thinker and writer with over a dozen books including his latest, “Muslim Vision of Secular India: Destination & Road-map”, “Qur’anic Pa radigms of Sciences & Society” (First Vol: Health), “Muslims Most Civilised, Yet Not Enough” and Other works include “The Devil of Economic Fundamentalism”, “The Essence of the Divine Verses”, “The Killer Sex”, “Islam means Peace” and “Rediscovering the Universe”.

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