Taleb Chalab Cham, MD** * Chairman and Assistant Prof., History of Medicine Department, Institute for the History of Arab cience, Aleppo !ni"ersity, Aleppo-yria The President of ISHIM (www.ishim.net) P.O. Box: 7581, !e""o, S#ri$ e-mail: ankaadan@gmail.com Phone 963 944 300030, Fax 963 21 223626 **Master de#ree student, History of Medicine Department, Institute for the History of Arab cience, Aleppo !ni"ersity, Aleppo-yria ummary Body Sustenance 1 had a special importance in Ibn Sina's 2 encyclopedia Al-Qanun fi-tib, as in other Islamic medical books. his important position appears throu!h t"o points# first of "hich by direct statement that keepin! the body health is ad$anced for healin! %restorin!& the ill body. Second throu!h the lon! recommendations that deal "ith body sustenance and hy!ienic issues. $ey %ords& body sustenance, pre$enti$e medicine, Ibn Sina, A$icenna, hy!ienic issues, Islamic 'edicine, Al-Qanun fi-tib. Introduction# 'he Muslim Physicians interested in pre"ention of diseases, and made it ad"anced to their treatment, and so Ibn ina thou#ht that sustenance is ad"anced to treatment of ill bodies, so his boo( Al- Qanun )i-tib contains recommendations that call for maintainin# #ood health and ta(in# into account the healthy conditions, and these notes are presented in t%o models& the first in chapters de"oted to * - (eepin# the health of the body. + - Ibn ina ,-./-0-12& A"icenna, Abu Ali al-Husayn ibn Abdallah ,3.3- */-.2, the #reatest Arab physician and philosopher of the 4ast, born in Persia. * topics related to hy#iene, and the second is the recommendations for maintainin# #ood health lay in the body of his boo(, durin# his e5planation of the disease and treatment plans. (ealth )eepin! In Al-Qanun *i-tib +auses of the diseases# Ibn ina refers at the be#innin# of the first part of his boo( to the importance of the causes of the disease, %hich are usually discussed in the chapters de"oted to Health maintenance in the Arab-Islamic Medicine. It is one of the foundations of Arab-Islamic Medicine, so Ibn ina sin#les out for these reasons, %hat he calls 6the first sentence of the second instruction, %hich contains nineteen chapters that e5plain these reasons, %here he refers to reasons di"isions, and their description as humeral or comple5 or related to mood * , and others produced by matters from outside the core of the body, and he says that the effect of one reason may "ary amon# the different bodies and different times. 'hen he cites reasons so-called chan#in#, and starts to e5plain the air as the first reason, %hich is considered an important element, and beyond bein# an important element of the bodies and souls to be an effecti"e factor, throu#h the processes of purification and recreation. Seasons and astrolo!y# 'hen he tal(s about the importance of succession of seasons, %hich affect the people throu#h the chan#e in their natures and moods, then he distinct bet%een t%o definitions of the seasons& the doctor7s definition and the astrolo#er7s. And stresses the importance of (no%in# the difference bet%een seasons and their diseases, to ta(e the necessary actions to pre"ent bodies from associated diseases. 'hen he refers that each season has a specific mood a#rees %ith a #roup of people, but it is contrary to another, so it causes diseases to them, but if the nature of the season chan#es, it %ill cause disease to all people, and this is a #eneral rule, about the impact of the seasons. 'hen he tal(s about the moods of the seasons, and the diseases caused by each season, that are suitable for this season, %ith reference to the diseases that are caused by impact of o"erlappin# seasons. * - Mood& aper"asi"e and sustained emotion that, %hen e5treme, can color one7s, %hle "ie% of life. Dorland7s Illustrated Medical Dictionary, 8. 9, aunders, Harcourt 9race :o"ano"ich, Inc, +. th ed, *311. + 'hen he tal(s about the chan#es that are ta(in# place accordin# to astrolo#ic reasons ,planets, and their e5cessi"e heatin#2, and accordin# to land property ,hei#hts, mountains, seas, %ind and soil2. He assures that the (no%led#e about these matters are "ery important to (no% the most %idespread diseases, ho% to pre"ent, and treat this diseases %hen they ta(e place. he effects of air and residencies# 'hen he defines the #ood air, and the factors that spoil the air, and the places %here the air is #ood, and the impact of spoiled air on the bodies. 'hen he describes the effects of the air accordin# to its ;uality& the impact of hot air is different from the influence of moderate, and the influence of cold or %et or dry, and e5plains the causes of air disturb and its impacts on the soul and body. He refers to some chan#es in air ;uality, such as the transition to be spoiled, and then tal(s about the impact of the %ind accordin# to their direction. 'hen he spea(s about the conditions of houses, and the residential factors that affect the bodies& the altitude, the nearby mountains, the nature of soil, bein# %ell %atered or deficient in %ater, and the surroundin# trees, minerals, and cemeteries and corpses. 'hen he states rules for selection of houses and ho% to prepare the residences, and stresses the need to (no% the diseases and health of the people of the country, and the conditions of %ater and %indo%s and doors and directions of %ind, and the entry of the sun. he effect of mo$ement. 'hen he tal(s about the effects of mo"ement on the human body accordin# to its se"erity and amount, the accompanyin# dormancy, and then describes the impact of each type. 8hen tal(in# about sleep he li(ens the sleep to dormancy, and the %a(efulness to mo"ement. It is note%orthy that the psycholo#ical mo"ements follo%ed or accompanied by mo"ements of the spirit, %hich is directed either out%ard or in%ard. he effects of food and drink. 'he foods and drin(s as Ibn ina says affect the body three %ays& ;uality, elements, and the nature. - And he says that the %ater is a corner, and that does not turno"er, because it carries food, and it is not a nutrient. 'hen he tal(s about the differences of the %ater, and attribute that to the %ater-born particles and their amounts. <ater in other chapters he addresses the conditions of healthy food, in terms of the type of food, its time, and its suitability to the desire, ta(in# into account not to be sub=ected to se"ere hun#er, and not filled to the point of satiety. 'hen he states the order of the food must be (ept in mind, and tal(s about eatin# habits. 'hen tal(s about drin(s, the #ood from the %ater and sno%, and ho% to reform the spoiled %ater, and then says that the #ood of the drin( is the %hite soft drin(. And then tal(s about the ;uality of %ater, dependin# on the nature of its "alley, direction, and its deposits. ,etention and emptyin! and other procedures. 'hen he e5plains three reasons of retention& the %ea(ness of the dri"in# force, or intensity of detent force, or %ea(ness of di#esti"e po%er. And spea(s about the impact of the emptyin# and con#estion in the body. In other places he tal(s about the procedures that are applied to the body, such as the types of bathes, and massa#es. 'hen he tal(s about the physical characteristics desired in the bathroom, the benefits of the bathin#, and e5plains its harms, and then he tal(s about the e5posure to the sun and the %arm sand and its effects in dryin# %etness of the s(in. In addition to these chapters there are many other independent chapters and notes about emptyin#, althou#h not listed in the maintenance of health issues such as in=ections and phlebotomy and cuppin#, leechin# * ,hirudini>ation + 2, emptyin#, %here he spea(s about ten thin#s must be ta(en into account durin# emptyin# to be ri#ht. 'hen he pro"ides a set of rules for the use of la5ati"es and nauseous dru#s, includin# food habits and the amount, the %ays, and times of food. And he de"otes a chapter about the diarrhea and its * - <eechin#& the application of leech for %ithdra%al of blood? formerly used e5tensi"ely in the treatment of "arious disorders? called also hi!"dini#a$ion. + - Hirudini>ation& *-. 'he process of renderin# the blood noncoa#ulable by the in=ection of hirudin. +- the application of leeches, leechin#. 0 la%s, a chapter about the mana#ement of the o"erabundant diarrhea, a chapter about the mana#ement of %ho used la5ati"es dru# and stayed %ithout diarrhea. A chapter about thin# must be done by the "omitin# person, a chapter about the benefits of "omit, another about the harmful effects of e5cessi"e "omit, and a chapter about mana#ement of o"erabundant "omitin#. 'hen he de"otes a chapter about enema, one of the bleed and cuppin#, and leechin#. he third art 'hen he de"otes the third art for the practical issues in the maintenance of health, this art consists of a chapter and fi"e instructions, each of them contains se"eral chapters. In the lonely chapter in this art, addressed ,in the cause of health and illness and the necessity of death2, he e5plains the reasons for health and disease, and summari>es the reasons that must be ta(en into account %hen loo(in# for health (eepin#, and be#ins to e5plain hy#iene issues in special #roups accordin# the follo%in# order& He be#ins to e5plain ho% to deal %ith ne"borns, especially the actions necessary at the time of the birth, and he ad"ises the breast feedin# from the mother. 'hen he cites the conditions that must be a"ailable in nursin# %oman, and ho% to mana#e the nurse %hen she needs. 'hen he ensures about ta(in# care of boy's ethics, for si5 years of his a#e. 'hen he tal(s about (eepin# adult7s health, and defines sport and its importance in helpin# the body emptyin#. 'hen he %orthily recommends that the best time for the sport is after di#estion of former food, and %ith empty stomach. And then de"otes si5 chapters to the mana#ement of a#ed people, %ho are classified as %ea( bodies li(e pre!nant "omen and ne%borns, %hich are discussed abo"e. 'ana!ment the old peoples. 'hen he starts by summari>in# the #eneral principle in mana#in# the old peoples& 6the use of moisturi>in# and heatin# factors li(e prolon# sleep, stayin# in bed more than youn#est, and the nature of the food. 'he food is "ery important in (eepin# health of elders, so he tal(s about the %ays and the necessary amount of food that must be #i"en to them, recalls of recommended foods, ad"ises to a"oid others, and @ recalls recommendations for the selection of the appropriate drin(s, and ho% to handle. 'hen he tal(s about the obstruction, massa#e, and sports of the old people. And there are miscellaneous issues of health (eepin#, such as the spea(in# about the importance of massa!es, %hich di"ided by the auther into rou#h, soft, abundant, and moderate, and he spea(s about their act on the body. 'hen he spea(s about the bathin# and its necessity for the person %ho needs moderate temperature and %etness, and states the conditions and ho% to use cold %ater %ashin#, %ith massa#e, sport, and anointment, and the #radual pro#ression to use it. 'hen he discusses the term 6sleep6, and mentions the benefits of moderate sleep, the dama#e of daytime sleep, the benefits of sleep at ni#ht, and the best position to sleep. 'hen he spea(s about stren#thenin# of the %ea( members, and #ro%in# their si>es. 'hen about the fati!ue and stretchin! the body, and ya%nin#, and e5plains the treatment of different (inds of fati#ue, and tal(s about the conditions resultin# from sports, li(e condensation, rarefaction, and e5cessi"e Hydration. 'hen he spea(s about mana#ement of bodies of bad moods. he mana!ement accordin! to moods. After that he tal(s about the mana#ement of the body %hose mood is #ood, and de"otes fi"e chapters about this. 'he abo"e is tal(in# about the mana#ement of the bodies %hose moods are moderate %ithout any alteration or e5cessi"e in one of the ;ualities, then he de"otes instruction IA containin# fi"e chapters to the mana#ement of bodies that suffer from mood chan#e. He starts %ith the mana#ement of the bodies %ith increased temperature, then %ith increased coolin#, then %ith rapid acceptance, and tal(s about fattenin# of the slim, and slimin# of the obese. 'hen he de"otes the fifth instruction to %hat are called transitions, and spea(s about the seasons. he mana!ement of tra$elers. After the end of seasons study he de"otes ei#ht chapters about the mana#ement of tra"elers, and mentions at first a #roup of symptoms that %arns the diseases, and B must be in mind, such as lon# lastin# palpitations, ni#htmare, di>>iness, and others. 'hen he states a #eneral rule for tra"elers is that the most important factor that affects the tra"eler is the chan!e of habits, fati!ue, and tiredness. Chapter III is de"oted to the pre"ention of sun heat, and the mana#ement of %ho tra"els in the sun. And he de"otes a chapter to the mana#ement of tra"eler in the cold. 8here he recommends that the tra"eler to massa#e his limbs until heated first, and then to coat them by %arm aromatic ointment. And he ad"ises to co"er face %ith stic(y thin#s, %hich conser"e its color. 'hen he assures that the different %ater causes many diseases to the tra"eler, and that is most important than the different food and, therefore, he emphasi>es the pre"ention of this diseases be mana#in# the %ater, and reminds the different methods of purifyin# the %ater. 'hen he states the symptoms associated %ith sea tra$el li(e di>>iness, nausea, and "omitin#, pro"ides recommendations for those %ho suffer them, and describes the medications and foods for the treatment of such cases. 'he pre"ious chapters are not the only chapters about maintainin# the health in Al-Qanun fi-tib, but there are a lot of recommendations about the sub=ect in this boo(, e"en %ithout mentionin# that it is related to the conser"ation of health. 'here are issues (no%n to be related to the maintenance of health, and Ibn ina considers %ithout reference to this relation, li(e the chapter about sleep and coma, in %hich he presents the definitions of natural sleep, hibernation, abnormal sleep, and the treatment of each type of hibernation, in addition to a chapter about sleep and stayin# a%a(e at ni#ht. Durin# the discussion of eye diseases he %rites a chapter about conser$ation of the health of the eye and %hat hurts it. And durin# discussion of the teeth in the se"enth art, the author de"otes a chapter about keepin! dental health, and tal(s about ei#ht thin#s must be ta(en into account to (eep healthy teeth. 'here are also chapters dedicated to thin#s related to the maintenance of health li(e chapter about thin!s suitable to stomach, in %hich he considers the suitable food to the stomach, and the best measures for most stomachs, and la5ati"es, and a chapter about thin#s that cause dama#e to the stomach, %here he discusses the dama#e of satiety . and fillin#, and some types of food, %ind and some medications and foods that are harmful to the stomach. Ibn ina tal(s about other issues related to the maintenance of health li(e a chapter called ,chapter about the benefits of se-ual intercourse2, and another about the ,se5ual intercourse and its harms, conditions, and bad types2, and another chapter titled ,chapter about times of se5ual intercourse2 states the conditions of intercourse and the proper times in relation to eatin# and sleep and other conditions, to a"oid dama#es of the se5ual intercourse. 'here is another important issue about the maintenance of health that is the maintenance of the health of pre#nant %omen, %hich comes under the headin# of .holistic mana!ement of pre!nant "omen., in %hich he tal(s about thin#s must be ta(en into account in pre#nant %omen li(e softenin# of the nature, moderate sports, %al(in#, bathin#, mo"ements, intercourse, foods and medications of pre#nant %omen, the mana#ement of the %omen %ho ha"e recently #i"en birth, the absence of desire, and the mana#ement of "omitin#, palpitations, s%ellin# of feet, and abortion. Infectious diseases. 'here is also a special chapter entitled 6the epidemic fe"ers and similar diseases6 in %hich he spea(s about smallpo5 and measles, and he says that they are caused by particles that chan#e the characteristics of the air, and this e5planation of the fe"er is similar to that pro"ided by the other physicians of the Arab Muslims, %hich su##ests that there is a holistic a%areness about air- borne particles that cause disease. 8hen he spea(s about smallpo5 he says that its occurrence is hi#her in boys, and it is in sprin#, more than in %inter, and he e5plains the si#ns of smallpo5. 'here is another topic about maintenance of health in the chapter entitled feedin# of con"alescent, %hich dra%s attention to special ;ualities of the food . ,esults and discussion# *- 'here is a main principle in the Islamic Medicine& 6(eepin# health of the healthy body is ad"anced to the treatment of ill one6, and this is ad"anced "ie%point, %hich is clear throu#h this boo( and other boo(s of Islamic Meicine, and this indicates the #reat ad"ancement in Islamc Medicine. 1 +- Ibn ina assures the importance of the outer causes or the en"ironmental causes in occurrence of the diseases, so they are essential factors in pre"entin# the diseases, and must considered in any researche about (eepin# the health of the body. -- Ibn ina assures the multiple factor cause of the disease, and that there are no one sin#le cause for disease, but there are e5ternal factors, and internal factors related to the nature of the body, and it7s mood, and the style of nutrition, drin(in#, a#e, and many other causes. 0- Ibn ina assures that the infectious diseases are transmitted by air-born particles, and that %e can pre"ent the spreadin# of infectious diseases by a"oidin# the direct contact %ith the ill persons, and this is a main principle in pre"enti"e medicine. @- Ibn ina directs special attention to specific #roups %ho are %ith hi#h ris( to special diseases, such as ne%born, pre#nant %omen, old persons, tra"elers, and pthers, and this also forms a branch of pre"enti"e medicine. B- 'here are many procedures must be done in order to (eep the balance bet%een the input and output of nutrients, and this is "ery important in (eepin# body health? and these procedures include the habits and nature of the food, and emptyin# procedures such as diarrhea, "omitin#, bleedin#, cuppin#, and others. +onclusion# )rom all of clues abo"e it becomes clear to us the importance that Ibn ina #i"es to health (eepin# sub=ects, li(e other Arab and Muslim physicians, and this appears throu#h prolon#ed te5ts about hy#iene, the ad"anced "ision of Arabic and Islamic Medicine, %hich ad"ances pre"ention to treatment, and emphasi>in# the "ie% that ha"e emer#ed in many of the medicine boo(s, %hich says that there are particles suspended in the air and %ater, cause diseases, and that %e can pre"ent infection by #ettin# rid of these impurities, and the remo"al of their sources, and this is consistent %ith the data of modern microbiolo#y, and to this the assertion that there are other factors inter"ene in the incidence of the disease, some of these factors related to body or to food and eatin# habits, or psycholo#ical conditions of the patient. It is also e"ident in full a%areness of the importance of clean en"ironment, housin#, and the so-called attention today to impro"e en"ironmental conditions for maintainin# 3 human health. And this reflects the #reat pro#ress and ad"ancement of the Arab and Islamic Medicine. ,eferences# *- Ibn ina. %l-&an"n 'i$-$ib. <ibanon, 9eyruth, Dar Alfi(r, *330. +- Ibn Abi !saybia. ()(* %+ %*,%% F- T%,%&%T %+ %T-,%. 9eyruth, DAC MA$'A9A' A<-HADA'. -- Dorland7s Illustrated Medical Dictionary, 8. 9, aunders, Harcourt, 9race :o"ano"ich, Inc, +. th ed, *311. 0- Ali ibn Al-Abbas Al-Ma=usi ,- -102. .amil al-/ana0a $ibbi1a. 4#ypt, Dar Ce(aby. */