The Origins of Humoral Medicine in Divine Revelation

The Relationship Between Prophetic Medicine and Humoral Medicine:

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All the books that explain the prophetic hadiths related to medicine are based on the principles of Humoral Medicine. Among them are Fath al-Bari Sharh Sahih al-Bukhari by al-Hafiz Ibn Hajar al-‘Asqalani; Mirqat al-Mafatih Sharh Mishkat al-Masabih by Shaykh Mulla ‘Ali al-Qari; Imam al-Nawawi’s commentary on Sahih Muslim; and Irshad al-Sari li-Sharh Sahih al-Bukhari by al-Qastallani. Whoever wishes may consult these works.

Humoral Medicine has its origins in divine revelation. In medical terminology, a “humor” refers to a wet, flowing substance; thus, the body’s fluids are called humors. They are four: blood, which is hot and wet; phlegm, which is cold and wet; yellow bile, which is hot and dry; and black bile, which is cold and dry. This is a religious and medical reality. Our shaykh, may Allah have mercy on him, believed that the human being was created upon the four humors, and this is also the view of the scholars of Ahl al-Sunnah wa al-Jama‘ah. Whoever denies this is ignorant, and his words are of no consideration.

Al-Hafiz Ibn al-Jawzi mentioned in his book Talbis Iblis that Allah Almighty created the children of Adam upon hotness, coldness, dryness, and wetness, and made their health dependent on the balance of the humors: blood, phlegm, yellow bile, and black bile.

Imam al-Zabidi stated in his book Taj al-‘Arus: “The temperament of the body is what it is composed of from the four natures: blood, the two biles, and phlegm. According to the philosophers, it is a quality resulting from opposing qualities.” He also said that one speaks of sound temperament and corrupted temperament, and that the body is founded upon the humors; people’s temperaments differ. He further stated: “The humors of the human being are his four temperaments upon which his constitution is built.”

Likewise, Imam Fakhr al-Din al-Razi stated in his tafsir: “As for your body, know that it is a substance composed of the four humors.”

In al-Misbah al-Munir by al-Fayyumi, it is stated: “Temperament (tab‘) is the innate disposition upon which the human being was created, and nature (tabi‘ah) is the human temperament composed of the humors.”

Questions were sent to Shaykh ‘Abdullah, may Allah have mercy on him, regarding Humoral Medicine, and among his answers were the following:

Was ancient medicine first practiced by the prophets?
The shaykh said: Yes, this is so. If not for the prophets, how would people have been guided to it? Then people, through experience, introduced further developments. Adam taught them its foundations, then Idris added to it, then Solomon also added to it, and then people, through experience, introduced many things. Solomon—when he would pray in his prayer place—a plant would grow and say to him: I was created for such and such.

The temperaments and humors—hot, cold, wet, and dry—who first brought this detailed classification and taught it to people?
The shaykh said: This came from some of the prophets, and then people expanded upon it.

Is the science of the pulse from divine revelation, and if so, to which prophet was it revealed?
The shaykh said: Its origin must necessarily be from one of the prophets, and others later expanded upon it. When Adam, peace be upon him, was brought out of Paradise, Allah taught him the craft of everything—this is reported in the hadith: all the foundations of livelihood. When Allah brought Adam out of Paradise, He provided him with fruits from Paradise; then, when those fruits descended from Paradise, their branches changed after coming down here—they did not remain in the state they had in Paradise. Those there do not change, whereas these here change and decay with time. Thus it is narrated by al-Tabarani.

How were the temperaments of herbs and animals known—was this through the prophets, and who was that prophet?
The shaykh said: Some of these matters came through the prophets, then people expanded upon them through experience. End of the words of Imam al-Harari verbatim.

The fatwa of Shaykh ‘Abdullah al-Harari (2002) regarding who is permitted to treat people medically, printed and published with the shaykh’s seal, states:

Imam al-Harari said: “The scholars are unanimously agreed that it is not permissible to practice—meaning directly engage in—medicine for treating illness for one who has no expertise and is not among the physicians. The Messenger of Allah ﷺ said: ‘Whoever practices medicine without being known for it is liable,’ narrated by Abu Dawud in his Sunan. The meaning of the hadith is that whoever does not know the properties of medicines and the conditions of diseases with the variation of times is forbidden to treat illnesses with herbs and the like. This knowledge is acquired through learning from people of expertise who know the natures of diseases and medicines—hotness, coldness, dryness, and wetness—and the variation of times with respect to diseases and remedies. It is therefore forbidden to rely merely on reading medical books to treat diseases without fulfilling this condition. Persisting in this is among the major sins, because it involves exposing lives and bodies to destruction. Whoever has done this must repent to Allah, and whoever took payment for it, that payment is unlawful for him. Selling medicine to a patient for use while lacking this expertise is forbidden, unless he sells it for the patient to present it to a physician for review and then use it; in that case it is permissible.”

Many people have practiced this medicine without proper knowledge, and destruction has occurred at their hands. Woe to the one who engages in this without sufficient expertise. One who does not know medicine and its principles should not say: “I prescribe medicine based on consulting a doctor by phone without the doctor seeing or examining the patient.” A doctor may prescribe based on the description given, but if he were to examine the patient, his diagnosis might differ and he would prescribe a different medicine.

Ibn Hajar said that the physicians said: “Our books are deadly poisons,” meaning for those who are not practitioners of the art—those who rely on medical books and treat people or treat themselves—like someone who gives poison to another or consumes poison himself. This is because a single medicine may benefit at one time and not at another, or may harm one person and benefit another due to differences in their conditions. End of the words of Imam al-Harari.

In conclusion, the words of our shaykh al-Harari, may Allah have mercy on him, are clear and unambiguous: the foundations of Humoral Medicine are revelation; this medicine has extended from the beginning of humanity until our present day; and the condition for treatment is knowing the state of the four natures in the human body—hotness, coldness, wetness, and dryness—so that the physician treats by using the opposite.

It is also well known to anyone familiar with the shaykh that he knew this medicine, treated himself with it, asked humoral physicians about remedies, and adhered to many treatments based on the principles of Humoral Medicine. Therefore, one should not pay attention to those who attack Humoral Medicine due to their lack of knowledge and understanding, but rather respond to them with scholarly refutations—and they are many.