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Lecture to 2nd year medical students on 23rd February 2001 by Professor Omar Hasan Kasule Sr

A. THOUGHT, fikr


 The Qur'an mentions intellect with the heart, qalb & ‘aql, (p. 962 22:46) an indication that the heart may have intellectual functions. The heart mentioned in the Qur'an is an anatomical structure of unknown identity but we know that the Qur'anic term qalb does not refer to the anatomical heart that we know. Intellect is often mentioned with Allah's signs, aql & ayaat (p 819-820 2:73, 2:164, 2:242, 3:118, 13:4, 16:12, 16:68, 23:80, 24:61, 26:28, 29:35, 29:63, 30:24, 30:28, 36:68, 37:137-138, 40:67, 45:5, 57:17). This close relationship is understandable because the signs can only be interpreted and understood by the intellect. Thinking, tafakkur, is encouraged by the Qur'an (p. 242 6:50, 7:184, 34:46). The Qur'an calls upon humans to think about the signs of Allah, al tafakkur fi ayat al Laah (p 53 2;219, 2:266, 3:191, 10:24, 13;3, 16:11, 16:69, 30:8, 38:29, 39:42, 45:13). Thinking is assisted by observation of  creation, al tafakkur bi al nadhar fi al afaq (p. 241 3:191, 7:185, 10:106, 29:20, 30;50, 50:6-7, 80:24, 88:17-24). The Qur'an makes it clear that those with intellect, ulu al albaab, understand Allah's signs (p. 170 2:179, 2:197, 2:269, 3:7, 3:190-194, 5:100, 12:111, 13:19-24, 14:52, 38:43, 39:9, 38:17-18, 39:21, 40:54, 65:10). The Qur’an condemns suppression/ misuse of the intellect, dhamm ta'atwiil al aql (p 818-819 2:44, 2:76, 2;170-171, 3:65, 5:58, 5:103, 6:32, 7:179, 8:22, 10:16, 10:100, 11:51, 12:109, 21:10, 21:67, 22:46, 25:44, 28:60, 29:63, 36:62, 39:43).



Conceptualisation and categorisation: Human history started with teaching Adam the names of all things (p. 38-39 2:31, 2:33).  This is the basis of knowledge and empirical research. By naming things it becomes possible to classify them and study the relations among different categories. This leads to concept-formation and general theories. Knowledge and understanding are in essence reducing many observed isolated phenomena to a few explanatory concepts. There is a neuronal basis for concept-formation and retention of such concepts for future reference in the cerebrum. With more research in brain physiology we will be able to understand the neurochemical mechanisms underlying these intellectual processes.


Measuring and counting: Human civilization made a great stride forward when humans learned how to count, assign a numerical value to a quantity. This became more sophisticated when they learned arithmetic, the manipulation of numbers. With the ability to count, it became possible to order and compare magnitudes of different things in a more precise way based on numeracy. Humans learned measuring and counting time, weight, and distance. These gave even more impetus to more sophisticated thought processes because thinking must be anchored in space and time for it to be realistic and useful. Measuring and counting became a tool that provided humans with definable concepts that can be used in reasoning.


Concrete and abstract thought: Simple intellectual processes involve manipulation of concrete ideas. More sophisticated intellectual processes involve manipulation of abstract ideas and concepts. Though of children is concrete until the age of puberty when they become able to reason in the abstract.


Causal reasoning: The Qur’an has given examples of both deductive and inductive reasoning. The human mind is able to understand causality and the reasons underlying various events and phenomena. The Qur'an has mentioned reason, sabab, in many instances (p 556 2:166, 18:84-85, 18:89, 18:92, 22:15, 38:10, 40:36-37).


Problem solving: Problem solving is a purposive intellectual process. Islam discourages speculative or hypothetical problems.


Intelligence assessment: Allah endows humans with a wide variety of types of intelligence. There is no single index of intelligence that can cover all of them.



The human intellect cannot reason out moral issues and be right all the time. Guidance on these matters should be from the revelation. Normative psychology is not accepted in Islam. For example a certain sexual orientation like sodomy does not become acceptable just because many people behave in a certain way.



The human mind is very creative and imaginative. It is therefore capable of creating illusionary realities. Imagination is good if it will lead to intellectual manipulation of concepts and ideas to produce some useful empirical facts and applications. It is useless and often positively dangerous if the illusions and imaginations are treated like reality. The Qur'an severely condemns dhann and calls for its avoidance, ijtinab al dhann (p. 69 49:12).



The intellect is the basis of judgment, al hukm al aqli (p. 343 6:136, 10:35, 16:59, 29:4, 37:154, 45:21, 6:36, 6:39). Humans differ in their interpretations of empirical facts. This is due to different background information, emotions, attitudes, and basic intellectual capability. These differences can be resolved by recourse to Allah's guidance, shar'a al llah, (p. 77-78 2:123, 2:213, 3:55, 4:65, 4:105, 5:43-44, 5:47-50, 6:164, 10:93, 16:39, 16:92, 16:124, 22:69, 27:76, 32:25, 38:26, 39:3, 39:46, 42:10, 43:63, 45:17).




Intellect and the senses: The Intellect needed for proper sensory perception: Intellect, 'aql, is related to the sense of vision ( p 820 2:7, 6:46, 6:110, 7:179, 16:78, 17:36, 23:78, 32:9, 45:23, 46:26).  Intellect is also related to the sense of hearing (p 820-1 2:7, 2:75, 2:171, 6:25, 6:46, 7:120, 8:22, 10:42, 16:78, 17:36, 18:57, 23:78, 25:44, 32:9, 45:23, 46:26, 50:37, 67:10, 67:23). The relation between intellect and other sense modalities is less pronounced because their sensory input into intellectual processes is relatively less. Sensory modalities that are concerned with autonomic activities have very little input into the intellectual process and the human is not consciously aware of their functioning.

Observation, tadabbur, and thinking, tafakkur: Observation and thinking are closely related. Observation consists of two processes: picking up sensory input from the environment and perception, interpretation of that information. The brain intellectual functions analyze the information and use it in many ways. This analysis is a type of human thought called concrete thought. The thinking mode of children before adolescence is predominantly concrete ie their thought revolves around real objects or events in the environment. Abstract thought develops after adolescence yet not all adults are capable of abstract thought. Even those who can think in the abstract, usually employ the much easier concrete thinking. Humans are encouraged to use their thinking faculties (6:50, 7:184, 34:46). The Qur’an encourages concrete thinking when it calls upon humans to think by looking and seeing (p241 17:48, 22:15, 25:9, 27:27, 27:33, 27:41, 37:102, 59:18, 74:21). Of special relevance to medicine is Allah's call to humans to think by observing their own bodies (p 242 30:8). Humans are encouraged to think about the signs of Allah (p 53  2:219, 2:261, 3:191, 10:24, 13:3, 16:11, 16:69, 30:8, 38:29, 39:42, 45:13,). Meditation is a type of ibadat and involves tadabbur. Itikaf is practical mechanism for tadabbur because it ensures relaxation and isolation from the general environment. Relaxation of the mind is needed for tadabbur. A quiet and stable environment also assists tadabbur. Too much environmental stimulation makes it difficult to concentrate in the observation and thinking. Salat al tahajjud has its major impact because it is offered at night when everything is quiet and the human can concentrate as well as think deeply about the creator and His signs.



Understanding,  fahm: Sensory perception is not sufficient. The sensory input must be understood. The source of understanding, fahm, is Allah (p. 909 21:79).  Allah has decreed variations in understanding among people. People do not have the same or equal understanding of the same facts (MB # 105 p 107-108).


Insight, idraak: Insight is a higher level of perception and understanding. Insight is a bounty from Allah. It varies from individual to individual. Even within the same individual it varies by the subject matter.


Judgment, hukm: Information from various sources may be apparently contradictory or may have to be combined to reach a reasonable conclusion. This calls for judgment. Judgment involves critically analyzing each piece of information, weighing and prioritizing it followed by considering it together with other pieces of information or with previous knowledge. Judgment is a necessity in a world in which phenomena are complex and multi-facetted. A set of values derived from revelation can guide human judgment and protect it from colossal mistakes.




The Qur'an has discussed consciousness, shu’ur, in several verses (p 632-633 2:9, 2:12, 2:154, 3:69, 6:26, 6:109, 6:123, 7:95, 12:15, 12:107, 16:21, 16:26, 16:45, 18:19, 23:56, 26:113, 26:202, 27:18, 27:50, 27:65, 28:9, 28:11, 39:25, 39:55, 43:66, 49:2). Shu’ur has both physical and moral dimensions. People in full possession of their sensory faculties may not be fully conscious of the evil and immorality around them.



Unconscious actions are monitoring, controlling, and pre-conscious. Dissociation actions are those that have become so regularly practiced that they are repeated without actively thinking about them like car driving. Physical consciousness is being aware and alert to environmental stimuli. It is mediated by the nervous system. Moral consciousness is being aware and sensitive to immoralities in the community. Most people have no moral consciousness; they see evil and feel no pain or distress. Having feelings about evil is the lowest level of iman. The higher levels are talking against evil or removing it physically.

Sleep is a special level of consciousness that will be discussed in due course. Some forms of music, dance, and incantations can produce an altered state of consciousness.



Anesthesia is a situation in which sensory perception has been reduced. It may be light or deep. Hypnotics and sedatives also affect the state of consciousness. They disturb both REM and non-REM sleep. Hypnotics lead to drowsiness and sleep. Sedatives calm anxiety and restlessness. Prolonged use of such drugs leads to dependence.



Hypnosis and various states of meditational change the consciousness of a person. Consciousness also changes when a person is in the depths of prayer with intense concentration. Too much fear like in pre accident can lead to loss of consciousness.



Qur'anic injunctions: The Qur'an discussed intoxication in various verses (p. 579 4:43, 15:72, 16:67, 22:2). It was also discussed in the books of sunnat (KS p. 217-221). The Qur’anic term khamr refers to any intoxicant be it solid, liquid or gaseous (Muslim #4956, 4957, 4958, 4959, 4960, 4961, 4062, 4963, 4964, 4966, 4967, 4968, 4969, 4970). All intoxicants must be avoided, ijtinab al khamr (p. 69 5:90). Use of khamr is forbidden for medicinal purposes (Muslim #4892). The Qur'an mentioned that alcohol has benefits and harms but that the harm is more than the benefit (p. 405 2;219, 16:67). The prohibition of alcohol came in stages, al tadarruj fi tahrim al khamr (p. 405 2:219, 4:43, 16:67) until it was finally prohibited (p. 405 5:90-91). The reason for prohibition is predominance of the evil (p. 405 4:43).


Ethanol, a type of alcohol and the commonest intoxicant used by humans down the ages, is not a stimulant but a general depressant like general anesthesia. It depresses the reticular formation that in turn stops stimulating the cortex. Alcohol starts by depressing previous training and experience that usually leads to self-restraint. It then impairs motor performance. In moderate doses it is useful in removing inhibitions. With higher intake judgment, observation, and attention are impaired. Still higher intake results into loss of control, childish behavior, motor and sensory impairment and finally sleep. Excessive intake causes medullary paralysis and eventually death. Alcohol has effects outside CNS on the cardio-vascular system, the gastro-intestinal system, and the kidney.

Social pharmacology & addiction: Drug dependence can be physical or psychological. The classification of legal and illegal drugs is arbitrary for example heroine is forbidden but alcohol is allowed yet alcohol causes more mortality and morbidity. Drugs that are socially acceptable like nicotine (tobacco) and caffeine (tea, coffee, cocoa) have serious adverse effects on health. Cannabis; found in three forms: marijuana, Indian cannabis (bhang, ganja, hashish) and hashish; has been used widely throughout human history and in many societies. There is an unfortunate movement towards its decriminalization. Sedative hypnotics are either barbiturates or non-barbiturates. Other agents that affect the mind and are addictive are: volatile solvents, anesthetics, opiates (opium and siamorphine), coca and cocaine, and amphetamine.




'Ilm is knowledge of the signs of Allah (p. 54 6:37, 6:97, 7:32, 9:11, 10:5, 27:52, 29:49, 30:22). ‘Ilm also includes understanding the signs, fiqh al ayat (p. 54 6:65, 6:98). Intellect is needed for knowledge, ilm & ‘aql (p. 821 29:43). The heart also has a role in knowledge and learning, ‘ilm & qalb (p 962 2:97, 2:118, 9:93, 16:78, 26:192-195, 29:49, 30:59, 47:24). 



Teaching and learning: Knowledge for the most part is not passively acquired, it has to be learned. Some people teach while others learn. The search for knowledge, talab al ‘ilm, is a noble pursuit.


Forms of learning: Learning can be by habituation, sensitisation, or conditioning. The Qur’an talked about a dog that barks in all conditions out of habit without making any distinctions (7:176). Any human experiences leave a mark on a human so that he is sensitised to future experiences of the same kind. A conditioned reflex is a type of learning.


Divine grace in learning: Prophet prayed for Ibn Abbas to get knowledge (KS p. 50). Allah put the truth on Omar Ibn al Khattab’s toungue, ja’ala al llaahu al haqqa ala lisaan ‘Omar (KS p. 397) and the Qur’an in many cases confirmed his opinions (KS p. 399).



Learning is memory: Memory is the basis for learning. What is not retained is not learned. There are differences in types of memory involved in learning. Learning history involves retaining facts and their interpretation. The memory involved in learning driving is unconscious.


Biological basis for learning and memory: There is a neuronal basis for learning and memory. New facts added to the memory caused changes in the architecture of neuronal and synaptic connections in the brain in a process akin to computer memory.

Parity in memory: Each hemisphere can act independently in learning and memory can be transferred between hemispheres. This indicates that facts memorized are stored in both hemispheres.


Short-term and long-term memory: Short-term memory can be abolished by trauma. Long-term memory cannot be destroyed easily. The elderly have better long-term memory than short-term memory. New facts added to the memory bank are structured by existing facts. They also can restructure the existing facts.



Purpose of human language: Language is the primary means of communication. Learning is closely related to language because humans think and manipulate verbal symbols.


Origin of human languages: There are 2 theories about the origin of human languages: de novo and evolutionary theories. Some linguists think that there was a primordial language that has now disappeared. As people spread in the world changes occurred in the language progressively until there were several dialects. With time each dialect became a distinct language with no apparent resemblance to other languages. The evolutionary theory asserts that the first humans had little communication. Their communication was limited to a series of sounds and grunts. With time these became more sophisticated and became words. The de novo theory seems more tenable in view of the Qur'anic story of the creation of Adam. It is most likely that there was a primordial language spoken by Adam that is the mother of all human languages.


Variation of human languages: The variation in human language is a deliberate design by Allah. It is a sign of his majesty and power. The fact that any human baby can learn properly any of the hundreds of human languages if exposed to it early in life


Levels of languages: Speech sounds such as the letters of the Qur’an alif-lam-mim have a meaning that we do not know. Human sounds like grunts can communicate messages. Speech sounds can be put together to make words, prefixes, suffixes that do not on themselves convey a complete thought. Words can be put together to make phrases and sentences. Some words in a sentence may be understood by implication when they are not said, mahdhuuf.


Understanding of language: Context helps understand language. Previous knowledge and experience also help in the understanding. Shared concepts between the two people communicating make the communication more effective. There are specialized languages like professional jargons eg journalese.



Human civilization has been able to grow because of the ability of humans to exchange ideas and to discuss, al hiwar al insani (p. 348-351 5:27-30, 12:43-55, 12:58-67, 12:69-100, 18:80-82, 27:29-35, 28:15-28, 37:101-102, 38:21-24). Communication facilitates family and social functioning. Communication helps in problem solving. It also helps in acquisition of new knowledge.




Denying the creator, kufr, is considered an intellectual aberration. A person with a sound mind should be able to appreciate naturally that there is a creator for all the signs in the universe. The Qur'an therefore describes the disbelievers as people who are suspending the use of their intellect, ta'atwill aql al kafir (p 1006 2:7, 2:170, 6:36, 6:50, 6:104, 6:122, 7:179, 8:22-23, 8:55, 10:42-43, 11:24, 13:16, 13:19, 17:72, 18:53, 21:45, 22:46, 25:44, 27:80-81, 30:52-53, 31:7, 35:19-22, 36:9-10, 40:58, 41:44, 43:40, 47:23-24).



Shirk is contrary to human nature, fitrat (p 629 7:172-173, 30:28, 30:30, 39:29).  Shirk is wahm (p. 629 6:148, 10:66, 12:40, 13:33, 29:41, 45:24, 53: 23, 53:28). Shirk is a failure of human thought due to blind following of forefathers, taqlid al aaba (p. 621 2:170, 5:103-104, 7:28, 7:70-71, 7:173, 10:78, 11:62, 11:87, 11:109, 12:40, 14:10, 21:52-54, 23:24, 26:72-77, 28:36, 31:21, 34:43, 38:5-7, 43:22-24, 53:23), ignorance, jahl (p. 622 10:68, 12:40, 18:5, 19:43, 22:71, 23:117, 29:8, 30:29, 31:15, 39:29, 39:14, 40:66, 46:4), and obeying shaitan, ta'aat al shaitan (p 622 16:63, 19:44-45, 19:81-84, 27:24, 29:38).


MADNESS, junoon:

The term madness is a vague term that can be used to mean different things to different people. It generally refers to a person whose behavior is different from what is common or average. Thus prophets were called mad because they lived clean lives amidst evil (p. 297 15:6, 26:27, 37:36, 44:14, 51:39, 51:52, 52:29, 54:9, 68:2, 68:51, 81:22). Madness or insanity as a psychiatric condition is an organic or psychological disorder leading to abnormal thoughts, emotions, and behavior.



Ignorance has two meanings and could be moral or cognitive. Moral ignorance, jahiliyyat, is failure to ‘see’ the right moral choices or the moral implications of observed empirical phenomena. This blindness may be deliberate in some cases. The Qur'an relates moral ignorance to kufr (p. 309-310 2:22, 3:154, 5:50, 5:104, 6:100, 6:108, 6:111, 6:140, 6:144, 6:148, 7:28, 7:138, 11:29, 16:56, 16:75, 19:43, 21:24, 22:3, 22:71, 27:55, 27:84, 30:29, 39:29, 39:64, 40:42, 46:23, 48:26, 53:27-30, 53:33-35). Cognitive ignorance, jahl (p 309 2:273, 4:17, 6:54, 12:89, 16:119, 49:6), is due to deficient factual information that can be cured by appropriate instruction.


THOUGHT DISORDERS, shudhuudh fikri

Thought disorders manifest as sterile argumentation, doubt, self-delusion, and conjecture. Sterile argumentations, jidaal, are those that lead to no useful purposes. Fruitless discussion and debate about the signs of Allah is a form of jidaal. Jidaal is misuse of human intellect that was condemned by the Qur’an (p. 44 40:4, 40:35, 40:56, 40:69, 42:35). Doubt, shakk, the denial of existing facts without definitely adopting alternative facts, was condemned by the Qur’an (p 639-640 2:282 … 74:31). It leads to instability of ideas. Clear thinking and reaching conclusions become impaired. Action is not possible. Shakk, can be positive in scientific investigation when it propels the scientist to look for new explanations and never rest with initial conclusions. It can be negative if there is doubt of absolute fundamentals like the attributes of Allah (SWT). Wahm can be seen as the opposite of shakk. It involves creation of new facts that are not real. It was condemned by the Qur’an (p 766-767 2:78, 4:157, 5:106, 9:45, 9:110, 10:94, 10:104, 11:62, 11:110, 14:9-10, 24:50, 27:66, 34:21, 34:54, 38:8, 40:34, 40:45, 44:9, 49:15, 50:25, 57:14, 65:4, 74:31, 84:14). Self-delusion, adhamat al insan al wahamiyat, occurs when human intellect deceives a person in thinking that he is more important than what he really is (p. 813 28:79, 43:31). This occurs when a human forgets that it is Allah who gives all honour and all bounties. A person who knows the power of Allah will never entertain delusions of grandeur. Transgressors like Pharaoh and Nimrod suffered from this disease. Dhann is a fixed suspicion that is not based on any facts described by the Qur’an as wahm (p 766-767 2:78, 3:154, 4:157, 6:116, 6:148, 10:36, 10:66, 17:52, 28:38-39, 38:27, 41:22-23, 45:24, 45:32, 53:23, 52:28, 84:14).


Professor Omar Hasan Kasule February 2001