"There is no contagion, there is no evil portent": Arabic Responses to Plague and Contagion in the...

“There is no contagion, there is no evil portent”:

Arabic Responses to Plague and Contagion in the Fourteenth Century

Robin S. Reich March 2, 2012

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The plague frightened and killed. It began in the land of darkness. Oh, what a visitor! It

has been current for fifteen years. China was not preserved from it nor could the strongest

fortress hinder it. The plague afflicted the Indians in India. It weighed upon the Sind. It

seized with its hand and ensnared even the lands of the Uzbecks. How many backs did it

break in what is Transoxiana! The plague increased and spread further. It attacked the

Persians, extended its steps toward the land of the Khitai, and gnawed away at the Crimea.

It pelted Rum with live coals and led the outrage to Cyprus and the islands. The plague

destroyed mankind in Cairo. Its eye was cast upon Egypt, and behold, the people were

wide awake. It stilled all movement in Alexandria.

– Ibn al-Wardi, Risāla an-Naba’ ‘an

al-Wabā’1

Between 747/1346 and 749/1349, Ibn al-Wardi, a poet, watched as the epidemic

commonly known as the Black Death2 marched across Asia and into the Mediterranean,

eventually reaching his home city of Aleppo. In the passage above, his trepidation at the coming

disease is apparent, as he reports of the plague felling entire populations. The Black Death was,

to Ibn al-Wardi, an unstoppable specter and he, as a poet, simply watched in awe as the disease

took its course. Though the disease raged on across Eurasia in recurring bouts for centuries, Ibn

al-Wardi’s account was cut short by his own death from the plague in 749/1349.3

The Risāla comes from the tradition within Arabic literature of plague chronicles, or

accounts of plague outbreaks. These works, which began during the first major era of plague in

the sixth century, reveal a continued fascination with the disease among Arabic writers.4 Beyond

1 Ibn al-Wardi, Risāla an-Naba’ ‘an al-Wabā’ (رسالة النبأ عن الوباء), trans. Michael W. Dols in Dickran K. Kouymjian,

ed. Near Eastern Numismatics, Iconography, Epigraphy and History (Beirut; American Univsersity of Beirut, 1974),

p. 448 (pp. 184-5). The title of this work translates to Epistle on Reports of the Pestilence. 2 Though there is a good deal of debate on which bacillus was responsible for the medieval plague, this epidemic is

typically identified as Yersinia Pestis. Though some scholars have claimed that outbreaks of plague were actually

simultaneous instances of a skin and lung condition, such as smallpox and pneumonia, this paper generally considers

plague to mean Y. Pestis. This is due to the specificity in Ibn Qayyim’s description of plague, as he carefully

identifies its bubonic form as the inflammation of glands in the neck, armpit, and groin. Though Ibn al-Wardi is not

so precise in his depiction of the plague, this paper works under the assumption that he is referring to Y. Pestis as

well for ease of consistency. 3 Michael W. Dols, “Ibn al-Wardi’s Risalah Al-Naba’ ‘An Al-Waba’, A Translation of a Major Source for the

History of the Black Death in the Middle East,” in in Dickran K. Kouymjian, ed. Near Eastern Numismatics,

Iconography, Epigraphy and History (Beirut; American Univsersity of Beirut, 1974), p. 445. 4 For more on plague chronicles, see Lawrence I Conrad, "Arabic Plague Chronologies and Treatises: Social and

Historical Factors in the Formation of a Literary Genre," Studia Islamica, No. 54 (1981): 51-93.

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simple personal reports of an epidemic, accounts such as Ibn al-Wardi’s attempted both to set

incidents of plague as historical events in their own time and to make sense of them. The Risāla

attempts to explain plague to its readers by attributing the infection’s physical symptoms to an

act of God, encouraging his audience to trust in God to deliver them from the catastrophe.

In retrospect, Ibn al-Wardi’s work raises a number of questions as to how writers of his

time understood contagious disease. How did educated people, faced with catastrophes such as

the plague, confront what was essentially an invisible enemy? How did they account for a deadly

illness that was not containable? Did the medical theory of the time have a means of explaining

disease transmission? Ibn al-Wardi’s contemporary, the Hanbali jurist5 and physician Ibn

Qayyim al-Jawziyya, also discusses plague in the course of his seminal work, at-Ṭibb an-

Nabawī.6 As Ibn Qayyim’s larger medical theory draws on a combination of the two perspectives

of medieval Arabic7 medicine, the Classical and Prophetic medical traditions, in order to

construct a comprehensive and widely acceptable medical theory, it would seem that his

discussion might help answer some of these questions. Indeed, within Ibn Qayyim’s discussion

of this larger medical theory, at-Ṭibb an-Nabawī deals with plague and contagion extensively,

devoting an entire chapter to each concept, as well as to the broader notion of catastrophe. Did

Ibn Qayyim, as a medical theorist, understand contagion differently than Ibn al-Wardi, who

witnessed the spread of the disease? This paper investigates the ways in which contagion, as a

5 Islamic jurisprudence (fiḳh) involves the interpretation of the Prophetic tradition to gain insight into Islamic law.

Within Islamic jurisprudence, the Hanbali school is one of several Orthodox interpretations that developed during

the ninth century. (I. Goldziher; J. Schacht. "Fiḳh." Encyclopedia of Islam, Second Edition. , 2012. Reference.

Carleton College. 29 February 2012 http://referenceworks.brillonline.com/entries/encyclopaedia-of-islam-2/fikh-

SIM_2364.) الطب النبوي67 For the purpose of this paper, the “Arabic world” is defined as any region or group in which Arabic is spoken or

written. It is important to recognize that inclusion in the Arabic tradition is not limited to Muslims, nor residents of

the Middle East, and that not only did this tradition extend into Europe, but even within the Middle East many of the

writers were Christian.

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defining feature of plague, was conceived of in these fourteenth-century Arabic writings.

Plague

As Arabic medical literature developed from its inception in the ninth century, the

discussion of plague became focused on the issue of contagion: contagion, as the most

inexplicable aspect of the disease, acted as a proxy for the plague itself.8 With this shift in focus,

however, plague continued to be the implicit context of much of the discussion of contagion.

While there is debate within the modern scholarly community as to what disease was actually

responsible for the medieval plague, it is widely believed to have been the bacillus Yersinia

Pestis.9 The plague has been identified as recurring in three major eras of pandemic: the

Justinianic Plague (sixth through second/ninth centuries),10

the Black Death (eighth/fourteenth

through eleventh/seventeenth centuries), and the plague of China (late thirteenth/nineteenth and

early twentieth centuries).11

Between these periods of pandemic, the plague also recurred in

scattered outbursts and came to be endemic in some areas.12

The Justinianic Plague was a

formative force in the Islamic world because of the coincidence of several events of early Islam

with the plague. It was during this pandemic that Arabic medical scholars began to discuss the

issue of contagion. Ibn Qayyim and Ibn al-Wardi, who both observed plague just prior to, or

8 See writings from this period, such as Ibn Ridwan’s “On the Causation of Bodily Ills in Egypt”, Ibn Sina’s “Canon

of Medicine”, and Qusta ibn Luqa’s “Medical Regime for the Pilgrim to Mecca”. 9Justin K. Stearns, Infectious Ideas: Contagion in Premodern Islamic and Christian Thought in the Western

Mediterranean, (Baltimore; The Johns Hopkins University Press, 2011), p. 89; Lester K. Little, "Life and Afterlife

of the First Plague Pandemic," in Lester K. Little, ed. Plague and the End of Antiquity: The Pandemic of 541-750,

(Cambridge; Cambridge University Press, 2007), p. 5. For the dissenting opinion, see Samuel K. Cohn Jr., "The

Black Death: End of a Paradigm," The American Historical Review, Vol. 107, No. 3 (June 2002). 10

Little, Plague and the End of Antiquity, p. 4. 11

Little, Plague and the End of Antiquity, p. 5. This plague pandemic is not generally called by any particular name,

but it is easily identified by its presence in China and India during this era. 12

Plague is believed to be endemic to the Nile valley dating back to the origin of the disease. Currently, plague is

endemic to prairie dogs in the American Southwest. See Eva Panagiotakopulu. “Special Paper: Pharaonic Egypt and

the Origins of Plague.”Journal of Biogeography, Vol. 31, No. 2 (Feb., 2004), pp. 269-275, and Jack F. Cully, Jr. and

Elizabeth S. Williams. “Interspecific Comparisons of Sylvatic Plague in Prairie Dogs.” Journal of Mammalogy, Vol.

82, No. 4 (Nov., 2001), pp. 894-905.

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during the beginning of the Black Death, are part of this line of scholarship as it continued on for

centuries.

Medical Traditions in Medieval Arabic Scholarship13

Medieval Arabic medicine engaged in debate along the lines of two main traditions,

which are integral to the discussions of contagion in both Ibn al-Wardi and Ibn Qayyim’s works.

One tradition was the Arabic interpretation of classical Greek medicine. This mode of thought is

distinguished by its theory of bodily humors and its basis in observation. The Classical tradition

inherited by the Arabs was mainly found in the works of Galen and Hippocrates, translated

beginning in the ninth century by Syriac Christians into Arabic.14

Though these works came into

Arabic relatively intact and continued to be primary medical texts for centuries to come, the

Arabic tradition developed the Classical tradition far beyond Galen and Hippocrates, developing

a new theory of medicine that built on the older one.15

While some Arabic works are obviously

part of the Classical tradition, such as Ibn Sina’s Canon of Medicine,16

it is often difficult to

identify when Arabic medical works continue this tradition because they rarely explicitly refer

back to Classical scholars or notions such as the bodily humors, even though those concepts may

underlie their explanations.

The other main tradition in Arabic medical scholarship was Prophetic medicine (at-ṭibb

13

In the context of this paper, I will refer to the medical tradition based in Islamic religious texts as “Prophetic

medicine” and to the Arabic continuation of the classical Greek tradition as “Classical medicine”. The pre-Islamic

folk medicine practiced in the Arabian peninsula also continued to have a presence in medical literature of this time,

mostly in the form of particular remedies and in the notion that benevolent or evil spirits were a factor in physical

health. This theory did not exist on its own, however; rather, Arabic folk medicine was typically integrated into the

other two theories to some degree, though it was still commonly practiced as a primary form of medicine throughout

the Arabic world. 14

Peter E. Pormann and Emilie Savage-Smith, Medieval Islamic Medicine, (Washington, D.C.; Georgetown

University Press, 2007), p. 9. 15

Dmitri Gutas, Greek Thought, Arabic Culture: The Graeco-Arabic Translation Movement in Baghdad and Early

'Abbasid Society (2nd-4th/8th-10th centuries), (London: Routledge, 1998), p.153. 16

Al-ḳānūn fī at-Ṭibb (القنون في الطب)

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an-nabawī).17

This tradition was developed in response to Classical medicine by religious

scholars, who drew medical theory from examples and adages in the Sunna, or the religious

literature of Islam comprised of the Qur’an and ḥadīth. Therefore, this medical theory was

modeled after the deeds, sayings, and religious recitations of the Prophet Muhammed, ultimately

claiming authority back to God. Prophetic medicine can be easily identified by references to the

Qur’an, ḥadīth, and scholars of Islam in its discussion of medicine.18

While Classical medicine

might appear to align with more modern notions of science-based physical medicine, both

traditions dealt with physical and metaphysical medical issues.

Historiography: Plague, Contagion, and “Religion” vs. “Science”

Contemporary scholarship, in contrast to medieval Arabic medicine’s focus on contagion,

has been primarily concerned with plague. While this study of plague has spanned disciplines to

include works on the medieval presentation of the disease and investigation into the microbe

itself, in addition to analyses of medieval reports of plague, modern scholarship has tended to

remain within certain ideological boundaries. Issues of geography, time period, and disciplinary

divisions have limited the extent to which historians have investigated issues such as contagion.

Plague in the medieval Arabic world is typically understood as a sub-genre of the broader

study of plague. Such studies tend to be concerned with Western Europe, particularly England,

because of the volume of both material and written sources there. Lawrence Conrad and Michael

Dols were the first to conduct a serious examination of plague in the Arabic-speaking world, but

there has been little advancement of this line of inquiry since the 1980s. While Conrad and Dols

17

This term (الطّب النبوي) is often translated as “Medicine of the Prophet”, but “Prophetic Medicine” is more accurate,

both to the Arabic grammar, and to the tradition itself, which did not apply medical theory professed by the Prophet,

but rather extrapolated on examples throughout Islamic religious literature to construct a medical theory. 18

Irmeli Perho, "Medicine and the Qurʾān." Encyclopedia of the Qurʾān. , 2012. Reference. Carleton College. 11

February 2012 http://referenceworks.brillonline.com/entries/encyclopaedia-of-the-quran/medicine-and-the-quran-

COM_00118.

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attempted to examine the Arabic world more broadly, most scholars since them have been

divided by both time period and geography. Therefore, the Justinianic Plague is typically an

issue of Byzantium, 19

while the Black Death has largely been studied in the context of Western

Europe. When studies have turned to the Arabic-speaking world, there is more flexibility in

regards to time, but the geographical division still remains, between the Iberian Peninsula and

western North Africa, and Egypt and the Near East.

It is perhaps because of these divisions that little investigation has been done, until very

recently, into the medieval understanding of plague, as opposed to a modern understanding of

medieval plague. As will be shown in this paper, plague and contagion were conceived of

differently within the medieval world than they are in the modern. With the perspective of

modern medicine, contagion and disease are viewed almost entirely as physical issues. However,

as will be discussed in the course of this paper, the medieval definition more inclusively

understood these concepts as issues of both the physical (the body20

) and the metaphysical (the

heart21

). To this end, discussions that have engaged with Arabic sources have tended to limit

their perspective by focusing only on either the “religious” or the “scientific” aspects of the

disease, conflating these with the Prophetic and Classical traditions, respectively, and largely

ignoring the integration of physical and metaphysical medicine.

Michael Dols’s The Black Death in the Middle East is the foundational study of plague in

the Arabic world and, while examining the plague as a multi-faceted phenomenon across a

number of fields, it established the trend of analyzing the religious and scientific aspects of the

19

This plague pandemic is named for the Byzantine emperor Justinian, under whose reign the plague began. 20

The Arabic term for body is badan (بدن). 21

“Heart” is meant in an almost metaphoric sense, as the center of cognition, emotion, and spirit. The Arabic term is

ḳalb (قلب). For more on the heart, see Jane Dammen McAuliffe. "Heart." Encyclopedia of the Qurʾān. , 2012.

Reference. Carleton College. 24 February 2012 http://referenceworks.brillonline.com/entries/encyclopaedia-of-the-

quran/heart-COM_00081.

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disease separately. Without much prior scholarship, Dols was confined to comparing the Arabic-

speaking world with the European, and so much of the framework for how the Arabic plague is

discussed is constructed by trends in the European literature. In examining the Christian efforts

to discover a moral cause for the plague, Dols points to a religious interpretation of the disease

by Muslim scholars.22

In so doing, Dols established a dichotomy between Christian and Muslim

responses to the plague, especially in reference to contagion, which has endured despite the fact

that this mode of thinking has largely been abandoned.23

Dols asserts that Muslim scholars did

not see plague as a divine punishment, a disease from which one should flee, or a contagion,24

which has also been shown to be inaccurate.25

While Dols’s intent appears to have been to draw

the Arabic world into the discussion of plague in Europe, by comparing two religious groups he

framed plague and contagion as religious issues within the Arabic world, and so scholars who

have built on his work have responded in kind.

Justin Stearns, whose Infectious Ideas is the work most immediately relevant to this paper,

is one of the recent works to continue Dols’s examination of plague and contagion as a religious

issue. Stearns examines concepts of contagion in Iberia during the Black Death in order to refute

Dols’s conclusions of inherent difference between Muslim and Christian interpretations of

contagion; however, he continues to perpetuate the limited perspective of contagion as a largely

22

Michael W. Dols, The Black Death in the Middle East, (Princeton; Princeton University Press, 1977), pp. 286-93. 23

Aside from the essentialism inherent to this kind of discussion, a division between Muslim and Christian scholars

becomes increasingly inaccurate when scholars take into consideration the fact that many Arabic writers were, in

fact, Christian. Furthermore, the cultural divisions being drawn between the Christian West and the Muslim East

break down when scholarship in Spain is included (which had prominent authors from both religions) and when the

flow of information is examined, as the Arabic sources derived the basis of their medical knowledge from the

translations of Ancient Greek sources by Syriac Christians, and that most of this medical knowledge only reached

western Europe through the translation of Arabic works. 24

Dols, The Black Death in the Middle East, p. 293. While Dols is not entirely incorrect in these assertions, Muslim

scholars did see reason to believe that the plague was a moral judgment from God, they did dictate situations in

which plague should be escaped, and they did understand that it was physically contagious. I will discuss all of these

further throughout this paper. 25

See Stearns, Infectious Ideas.

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religious issue.26

By categorically separating religion from medicine, Stearns fails to see how

religious medical interpretations blended with other traditions.

While Stearns locates religious medical interpretations within the larger Arabic medical

tradition, his discussion is mostly concerned with interpretations derived from the Qur’an and

ḥadīth. Furthermore, because of Stearns’s focus on religious interpretations, there is a sense

throughout his book that the religious tradition of Prophetic medicine is inherently at odds with

the conclusions drawn by Arabic physicians who followed the Classical tradition. As a result of

this, Stearns sets religion and medicine at odds, perpetuating the fundamental misunderstanding

that the Prophetic medical tradition believed plague was not contagious.27

Despite Stearns’s

criticism that others in the field have held essentialist views of medieval medicine by religious

affiliation, he himself allows the medicine theorized by Muslim scholars to be defined solely by

their religious beliefs and largely sees the integration of non-Prophetic medicine as the

exception.28

In contrast, Peter Pormann and Emilie Savage-Smith, in their book Medieval Islamic

Medicine, have characterized medieval Arabic medicine as a field primarily based in advancing

the Classical tradition, with Prophetic medicine on the fringe and largely non-medical.29

While

they even describe Ibn Qayyim’s at-Ṭibb an-Nabawī as “composed to reconcile the traditional

medicine of Arabia and the revelations of Muhammad with ideas and terminology from the

Greek-based system,”30

most concepts touched on in their book are explained in terms of

“Greek-based” theory. In their discussion of contagion, for instance, ḥadīth are mentioned more

26

Stearns, Infectious Ideas, p. 167. 27

Stearns, Infectious Ideas, p. 36. 28

Stearns, Infectious Ideas, p. 74. While Stearns is correct in asserting that a theory, such as Ibn Qayyim’s, which

draws equally from the Classical and Prophetic traditions is rare, most medicine was not strictly confined to either

side, and incorporated elements of both traditions. 29

Pormann and Savage-Smith, Medieval Islamic Medicine, pp. 41-75. 30

Pormann and Savage-Smith, Medieval Islamic Medicine, p. 73.

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as conflicted and unspecific sources of largely illogical information, rather than as well-

considered medical theories. In contrast, their discussion of the theories of ninth-century

Egyptian medical writer, Ibn Ridwan, sees his work as valid medical reasoning because it draws

more heavily from the Classical tradition.31

Both Infectious Ideas and Medieval Islamic Medicine draw a division between medical

theory and religious interpretations that pertain to medicine. This division appears to distinguish

religion from science, on the basis that religion deals with issues of the soul and a personal or

societal relationship with God, and science deals with issues of the body. This division is not

only problematic in that it applies a modern notion of academic disciplines to a medieval mode

of thought, but also in that it conflates the Classical tradition with physical medicine and the

Prophetic tradition with spiritual medicine. This entirely abandons issues of the mind, which, as

this paper will show, was integral to medieval Arabic medicine, and also ignores the fact that

both the Classical and Prophetic traditions deal with the body as well as the soul and the mind.32

Within this paper I examine the way in which the seminal Prophetic medical text, at-

Ṭibb an-Nabawī of Ibn Qayyim al-Jawziyya, conceptualizes the notion of contagion. Through

this examination I reveal Ibn Qayyim’s theory of contagion as one that encompasses both

physical and metaphysical means of disease transmission, and discuss the ways in which these

two aspects of contagion are, in fact, complementary to one another. With Ibn Qayyim’s

understanding of contagion in mind, I return to Ibn al-Wardi’s plague tract to compare theory to

epidemic reality. In the course of this discussion, I show that medieval Arabic thinkers such as

Ibn Qayyim and Ibn al-Wardi drew on a hybrid medical tradition to conceptualize contagion as a

matter that extended beyond the physical and into the metaphysical. Furthermore, by analyzing

31

Pormann and Savage-Smith, Medieval Islamic Medicine, pp. 58-9. 32

The soul and mind will hereafter be combined within the notion of the heart.

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their understanding of contagion as a response to the plague, I show how this theory of contagion

calls forth issues that strike at the fundamental assumptions of medieval medicine, which in turn,

reveal various sources and modes of thinking within medieval Arabic scholarship.

Part I: Ibn Qayyim and the Theory of Contagion

Background: Ibn Qayyim and at-Ṭibb an-Nabawī as a text

Ibn Qayyim’s discussion of contagion comes couched in his medical guide, at-Ṭibb an-

Nabawī, a rare thorough examination of medical belief. It was likely written sometime after Ibn

Qayyim began his apprenticeship to the prominent physician Ibn Taymiyya in 710/1310 and

before his death in 751/1350. 33

Though it is difficult to locate a manuscript of at-Ṭibb an-

Nabawī published before the nineteenth century, Ibn Qayyim, especially as a student of Ibn

Taymiyya, is seen by contemporaries and modern scholars alike as an important medical

writer.34

That at-Ṭibb an-Nabawī as a book does not appear to have been widely spread does not

mean that its ideas were unknown to contemporary scholars, as his essay actually constituted a

part of a much larger work, and pieces of it are scattered throughout Ibn Qayyim’s other

publications.35

Additionally, as will be discussed later, concepts from Ibn Qayyim’s work can be

seen in other contemporary writings, whether because their authors were influenced by him or

because they shared similar ideas. In either case Ibn Qayyim’s work comprehensively explains

33

A note on reference to Ibn Qayyim’s work: I worked primarily from Penelope Johnstone’s translation, and so

quotes and page numbers are from this edition. However, I also compared Johnstone’s translation to an Arabic

edition, in which chapter divisions were not the same. I list the corresponding pages for the chapters I primarily

reference on page 13 of this paper. When referring to text from the introduction, I cite Johnstone as the author of this

work, but otherwise I attribute this translation of at-Ṭibb an-Nabawī to Ibn Qayyim. 34

H. Laoust. "Ibn Ḳayyim al-D j aw iyya." Encyclopedia of Islam, Second Edition. , 2012. Reference. Carleton

College. 28 February 2012 http://referenceworks.brillonline.com/entries/encyclopaedia-of-islam-2/ibn-kayyim-al-

djawziyya-SIM_3242. 35

Penelope Johnstone, "Medicine of the Prophet," (Cambridge; The Islamic Texts Society, 1998), p. xiv.

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these theories of his time and so invites modern readers into a particular perspective of his period.

Ibn Qayyim, as a scholar, stood in two traditions. Both a Hanbali jurist and a physician,

Ibn Qayyim devoted himself to law and medicine, by study and practice. A native of Damascus,

Ibn Qayyim S h ams ad-Dīn abū Bakr Muḥammad b. Abī Bakr a -Zarʿī began his training as a

physician under the tutelage of Ibn Taymiyya in the early eighth/fourteenth century. Around the

same time, he also began to study Islamic jurisprudence, learning the foundational texts of Islam

in order to interpret an appropriate legal ruling. It is apparent from at-Ṭibb an-Nabawī that Ibn

Qayyim was not strictly tied to any one discipline, with his legal analysis guiding his medical

writing. While Ibn Qayyim’s work is fully focused on the topic of medicine, his method of

addressing every interpretation of a given issue that he saw as valid is obviously a reflection of

his juridical training. This hybridity of allegiance shows through in the content of Ibn Qayyim’s

work as well, both in the two medical traditions that inform his perspective, as well as the hints

of mysticism that suggest that even his religious perspective was not firmly rooted in one

interpretation.36

Ibn Qayyim’s work is structured to cover a broad range of medical topics and perhaps

even acted as a medical reference text for other physicians. It is split into two parts: the first

discusses, topic by topic, types of disease and treatment,37

supported by the words of the Prophet

and Ibn Qayyim’s medical predecessors, both Greek and Arab; the second part is more of an

encyclopedia of naturally occurring medicinal substances, mostly plants and minerals native to

36

Ibn Qayyim, though he does not appear to have followed the practice of Sufism, makes reference to Sufi ideology

throughout his work, as in this passage: “[The power of evil spirits] continues so long as they are not repelled by

some defence [sic] stronger than their causes, such as dhikr and prayer, supplication and entreaty, almsgiving and

recitation of the Qur’an.” (Ibn Qayyim al-Jawziyya, Medicine of the Prophet, trans. Penelope Johnstone,

(Cambridge; The Islamic Texts Society, 1998), pp. 28-9.) The specific reference to the Sufi practice of dhikr

suggests that Ibn Qayyim was rather liberal in his practice of Islam, accepting influence from a variety of traditions. 37

For more detail on Ibn Qayyim’s division of medicine, see Appendix A.

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the Levant and Arabian Peninsula.38

These two sections comprise a medical text that appears to

strive for completeness, covering almost every conceivable ailment with a thorough discussion

of its causes, symptoms, treatments, and precedents in medical literature. Ibn Qayyim even lays

out the medical debate on many topics, offering to his discriminating audience a variety of

interpretations. This methodology reveals in Ibn Qayyim a thoughtful jurist and practitioner, who

seeks to consider all possibilities in order to arrive at the truth, rather than to be correct in his

own interpretations. It is with this open perspective that Ibn Qayyim confronts the debate on the

nature of contagion.

Ibn Qayyim’s Conglomeration of Arabic Medical Traditions

Although Ibn Qayyim’s treatise is titled “Prophetic Medicine,” this work bridges the gap

between the Prophetic medical tradition and the Classical.39

Ibn Qayyim’s work, deriving from

both the Classical and Prophetic traditions, refers back to, and thus likely draws information

from, most of the seminal authors of each tradition. In a section at the end of at-Ṭibb an-Nabawī,

in which he shares some general wisdom for good health, most of his discussion is a list of

references to the important sayings of every major physician he can name. These include Galen

and Hippocrates, as well as Imams, ḥadīth, a host of Arab physicians, and philosophers.40

They

are listed in no particular order, with no division by tradition. Ibn Qayyim simply represents

them all as authorities on medicine and, in so doing, makes it clear to his reader that his work sits

at the crossroads of all these traditions.

Ibn Qayyim’s reliance on both Classical and Prophetic medicine is also apparent

throughout his discussion of his theories. He typically uses evidence from both traditions to

38

For a list of common ailments and cures within this work, see Appendix B. 39

Because of the focus of this paper, the Classical tradition is often not as apparent in the excerpts of at-Ṭibb an-

Nabawī given here. For more on the Classical tradition in Ibn Qayyim’s work, see Appendix B. 40

Ibn Qayyim, Medicine of the Prophet, pp. 283-8.

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support a given medical opinion, as when prescribing that those in a plague-ridden area should

remain there:

When plague occurs, it is necessary to rest quietly and to quieten the disturbance of

the humours. It is possible to travel away from a land where there is pestilence only

with a great deal of activity, and this can have a damaging effect. This is the opinion

of the most excellent of physicians and of modern writers. This latter medical opinion

corroborates the same concept which is contained in the prophetic ḥadīth and its

concern with treatment and welfare of heart and body.41

This passage states that one should remain in a land with plague because it is necessary to rest,

though it is unclear whether this is to prevent the contraction of the disease or to preserve health

after contraction. Ibn Qayyim guides his reader to explanations in both medical traditions for this

practice. The Classical tradition, he says, believes that movement is likely to disturb the balance

of the bodily humors, while the Prophetic, though not expanded upon here, states that both the

physical and mental stress of traveling are too much for a person who is or may become very

ill.42

Ibn Qayyim finds agreements such as this throughout his medical theory in order to show

that the two traditions have many of the same underlying beliefs. While there are situations in

which the traditions are not so synchronous, because one either approaches a topic that the other

does not, or deals with it differently, Ibn Qayyim continues to find ways of reconciling the two

traditions out of his allegiance to both.43

The weaving together of these two traditions is essential

to Ibn Qayyim’s discussion of contagion, as his theory joins the traditions to strengthen his

argument.

As Ibn Qayyim does not explicitly outline his theory of contagion, my analysis of at-Ṭibb

41

Ibn Qayyim, Medicine of the Prophet, pp. 30-31. 42

Ibn Qayyim, Medicine of the Prophet, p. 31. 43

While modern scholars have often interpreted at-Ṭibb an-Nabawī to exist primarily in one tradition, drawing in

the other in order to justify it, there is no strong evidence in the text to suggest that Ibn Qayyim sees himself as more

deeply rooted in either Prophetic or Classical medicine, nor that he is addressing the scholars of either tradition in

particular. While some modern scholars (whose work I have discussed in my section on historiography) have

claimed that at-Ṭibb an-Nabawī is a work primarily concerned with legitimizing Prophetic medicine within the

Classical tradition, this work is not structured with either medical tradition as a main reference point, and both

traditions are used equally to legitimize and support the other.

14

an-Nabawī extracts this theory from various points throughout the text and joins them together.

The parts of the text that primarily inform this analysis are: the overview of Ibn Qayyim’s

medical theory,44

the sections on the treatment of the plague,45

the sections on the treatment of

contagious diseases,46

and the sections on the treatment of calamity.47

My analysis works

through these sections in order to derive a theory of contagion that is consistent with the aspects

of Ibn Qayyim’s medical perspective that are stated explicitly.

I analyze at-Ṭibb an-Nabawī in five stages. 1) I examine the larger structure of Ibn

Qayyim’s medical theory in order to understand the main division of heart and body that appears

in his theory of contagion, as well as to locate contagion within this theory. 2) I then examine the

various Arabic words Ibn Qayyim uses to discuss contagion and the range of meanings the word

“contagion” carries in English. 3) The core of my analysis draws the delineation between heart

and body out of a discussion of leprosy and plague. Within this discussion I distinguish between

three different types of contagion of the heart and show how Ibn Qayyim believed one, contagion

via stigma, to be illegitimate. This discussion of stigma particularly illustrates how the

distinction of heart and body is used to create a consistent narrative between the various elements

of medieval Arabic medical literature by explaining an oft-discussed ḥadīth. 4) My discussion

elaborates on this last point by addressing the issue of ḥadīth that appear to disagree on the

nature of contagious diseases. 5) Finally, I analy e Ibn Qayyim’s discussion of contradictory

ḥadīth about the plague, both to extend the applicability of Ibn Qayyim’s theory to the specific

issue of this disease, and also to explore how Ibn Qayyim intended to balance the two elements

44

Chapter 1 in Johnstone. Johnstone’s translation assigned chapter divisions to the text that do not appear in the

version of the text I have in Arabic, and that likely did not appear in the original text. These divisions combine many

of the sections that were otherwise separate in the original Arabic. Chapter 1 is titled, “Introduction and general

considerations.” The Arabic text of Ibn Qayyim (at-Ṭibb an-Nabawī, (Beirut; Mu'assasat al-Risalah, 1980)) covers

this content on pp.1-17. 45

Chapter 5, “Treatment of plague and precautions against it,” in Johnstone, pp. 28-34 in Arabic. 46

Chapter 27, “On the progression of illness and contagious disease,” in Johnstone, pp. 116-120 in Arabic. 47

Chapter 32, “Treatment for Calamity” in Johnstone, pp. 141-175 in Arabic.

15

of heart and body in a situation in which the physical aspects of the disease were largely

considered incurable.

Contagion: Heart and Body

Contagion, Ibn Qayyim explains, has its place in a well-organized structure of disease.

Ibn Qayyim divides sickness into two types: that of the heart and that of the body. By the heart,

Ibn Qayyim means the aspects of a person that are metaphysical: his soul, spirit, emotional

disposition, and mentality.48

The body is confined to the purely physical aspects of a person,

such as skin, organs, and humors or bodily fluids. Though the two types of sickness are often

intertwined, as Ibn Qayyim cautions his reader from ignoring the heart for the sake of the body,49

they are in many ways distinct. This distinction helps to explain some of the basis for the entire

medical theory that is at-Ṭibb an-Nabawī, as Ibn Qayyim dictates different kinds of treatments

depending on which side the type of sickness falls. However, the treatments are most often

applied in some combination, as ultimately the person is one whole comprised both of heart and

body. 50

According to Ibn Qayyim’s discussion of contagion, transmissible disease straddles the

distinction between heart and body. Contagious diseases, Ibn Qayyim explains, attack both the

physical organs of the body, disrupting the balance of humors and corrupting the materials of

which the body is made, and eat away at the heart, sowing doubt and anxiety and challenging the

faith of the afflicted individual. He says,

Undoubtedly there may be in the body some latent preparedness and readiness to

48


“As for Medicine of the Heart, this has been entrusted to the Messengers, God’s blessing and peace be upon them;

there is no means of obtaining this, except through their teaching and at their hands. For the tranquility of the heart is

obtained through recognition of its Lord and Creator… Any idea that health of the heart can be achieved except by

following them is an error on the part of the one who so thinks unless he only means the life and health of his animal

soul and its desires, while the life of his heart, its health and strength, are totally ignored.” (Ibn Qayyim, Medicine of

the Prophet, p.5) 50


16

succumb to this disease, and the nature [of the body] may be quite susceptible, disposed

to accept disease from the bodies of those it has contact with. For indeed it is able to

transmit disease in this way. Now the constitution’s fear and imagination concerning that

can be among the most potent causes for that disease to attack it. Indeed imagination has

a powerful influence upon faculties and constitutions. 51

So, a single disease can transfer from one person to another either by means of the recipient’s

body, or their ‘constitution’.52

By applying this description of the transmission of contagious disease to Ibn Qayyim’s

system of disease classification, it appears that contagious diseases may be found in two

categories of illness outlined in Ibn Qayyim’s theory. Contagion may first be a means of

physically transmitting diseases of the body by causing the body to depart from its natural state,

as is the case with what Ibn Qayyim refers to as “general disease”.53

Contagion may also be a

means of metaphysically transmitting diseases of the heart, by afflicting an individual with

anxiety, especially in relation to God, as in the sickness of “uncertainty and doubt”.54

Contagion,

by the above passage, afflicts both heart and body, depending on the given illness. As I will show,

however, this division between heart and body is not well defined, and so there is an element of

illness of the heart to every illness of the body. Similarly, some diseases, such as plague, exist as

diseases of both the heart and body, and so may be transmitted by means of both. For this reason,

contagion, in addition to being a means of spreading disease, also constitutes its own

51


“Constitution” here means a person’s metaphysical constitution, including their emotional disposition, mental

state, and sense of faith. 53


“In their hearts is a disease; and Allah has increased their disease.” (II:10) (Ibn Qayyim, Medicine of the Prophet,

p.3)

“That those in whose hearts is a disease, and the unbelievers, may say: What does Allah mean by this as a parable?”

(LXXIV:31) (Ibn Qayyim, Medicine of the Prophet, p.4)

“When they are summoned to come to Allah and His Messenger so that He may judge between them, behold some

of them decline. But if the right is on their side, they come to him in submission. Is it that there is a disease in their

hearts? Or do they doubt, or are they in fear, that Allah and His Messenger might treat them unjustly? But it is they

who do wrong?” (XXIV:48-50) (Ibn Qayyim, Medicine of the Prophet, p.4)

17

classification within the structure of Ibn Qayyim’s theory.55

Contagion: multiple meanings

As Ibn Qayyim’s discussion of disease transmission reveals, “contagion” carries a variety

of meanings, between the Arabic words used to connote contagion within Ibn Qayyim’s theory,

as well as within the language I will use to discuss that theory. Ibn Qayyim’s work uses three

different Arabic words to denote contagion in different contexts. Even when the same word is

being used, though, there are three different ways in which it might operate in relation to the

disease. Beyond this, Ibn Qayyim’s theory of contagion may also be divided into four separate

means of transmission, but I will address these in a later discussion. In separating the various

meanings of ‘contagion’ I will show how Ibn Qayyim’s medical theory uses an understanding of

both physical and metaphysical medicine, derived from both the Classical and Prophetic medical

traditions, to explain the contagious specter that was plague.

Linguistically, translators of Arabic medical texts into English have allowed three Arabic

words to be translated or to connote the meaning of the English word ‘contagion’: ṭā’ūn,56

wabā’,57

and ‘adwā.58

For the first two words, Ibn Qayyim explains these terms in his book:

“wabā’ and ṭā’ūn differ, one representing the general, the other the particular; every plague

[ṭā’ūn] is a pestilence [wabā’], but not every pestilence [wabā’] is a plague [ṭā’ūn].” 59

Here, Ibn

Qayyim tells his reader that if wabā’ and ṭā’ūn are both diseases, wabā’ is a broader category of

55

I detail the structure of this classification in my discussion of Ibn Qayyim’s theory of contagion, and a schematic

of this structure may also be found in Appendix A. 56

طاعون وباء5758

This issue, which I will return to later in this paper, has led to a problematically limited reading of Islamic (عدوى)

medical writings in general. Since these words, and others, have been reduced to the simple ‘contagion’ in English,

much of the context and larger meanings of these words have been removed. In some cases, this has resulted in

English-speaking scholars expanding a concept about a given disease to all contagious diseases in general, and in

other cases it has led scholars to see ideological conflict where it is not. Though this issue is most apparent in

translated works, it exists throughout the English-language literature on this topic. 59

Ibn Qayyim, Medicine of the Prophet, p. 28.

18

diseases that can become widespread, perhaps referring to communicable diseases in general, or

it might indicate the broad concept of communicability. However, it is clear from the wide usage

of wabā’ that the word does not translate directly to “contagion” or “pestilence,” even though it

is translated this way in the above quote. Ṭā’ūn, as the more specific term, indicates a particular

type of disease, which Ibn Qayyim explains elsewhere is a glandular inflammation. While ṭā’ūn

was used throughout Arabic medical literature for centuries to denote plague,60

based on Ibn

Qayyim’s definition this term could be applied to a wide range of inflammatory diseases and

skin conditions. Furthermore, the plural of ṭā’ūn, ṭawa’īn, indicates infectious disease more

generally.61

In many cases, ṭā’ūn and wabā’ are used interchangeably, perhaps to denote

particular aspects of a given instance of disease.62

The third term, ‘adwā is not very widely used, but it is the term translated as “contagion”

in the oft-quoted ḥadīth, “there is no contagion, there is no evil portent.”63

There are no

elucidating definitions of ‘adwā, and given the variety of interpretations of this ḥadīth in

medieval literature it is not clear that a consistent definition was used even when this term was

common in Arabic. It does appear, however, that ‘adwā denotes communicability or infection in

some way, in some cases referring specifically to disease, in others corresponding to a broader

notion of transference or corruption

‘Contagion’, as it is used both in English and within Ibn Qayyim’s writing, can also

indicate a variety of different operations in relation to the disease: it can be a disease itself, the

60

See Lawrence I. Conrad, "Ta'un and Waba': Conceptions of Plague and Pestilence in Early Islam," Journal of

Economic and Social History of the Orient, Vol. 25, No. 3 (1983), pp. 268-307. Ibn Qayyim very clearly identifies

ṭā’ūn as bubonic plague in one part of his text, but insinuates that the disease presents in other forms, including

pneumonic, which aligns with the modern understanding of the disease. However, it is not clear that ṭā’ūn always

refers to Yersinia Pestis in any of its forms, or to one particular disease at all. 61


See also, "Wabāʾ." Encyclopedia of Islam, Second Edition. , 2012. Reference. Carleton College. 22 February 2012

http://referenceworks.brillonline.com/entries/encyclopaedia-of-islam-2/waba-COM_1320. 63


http://referenceworks.brillonline.com/entries/encyclopaedia-of-islam-2/waba-COM_1320

19

act or means of transmitting disease, or the stigma associated with those afflicted by a disease.

For the first two meanings, ‘contagion’ carries much the same meaning as in English: a disease,

such as influenza, can be a contagion in that it is capable of being transmitted from one person to

another, or saliva may be a contagion because it potentially carries the germs of a given disease.

It is important to note, however, that though Ibn Qayyim and his contemporaries did identify

things like exchange of breath and bodily fluids as possible means of contracting disease, they

did not have an explicit concept of germs or some other specific agent of disease. Contagion as

stigma has a meaning that is more heavily contextualized in the medieval world. In this sense,

Ibn Qayyim refers to people who believed that those afflicted with a disease were in some way

personally tainted, and so became ostraci ed. Therefore, ‘contagion’ can also indicate a social

aspect of a disease that has become associated with those who have contracted it.64

These many meanings of the term ‘contagion’ show how the concept of a contagious

disease transcends physical medicine and becomes a matter of what Ibn Qayyim would call the

heart. What inherently distinguishes a contagious disease from any other is that it can be passed

from person to person, and, Ibn Qayyim explains, “the physicians have nothing whereby to repel

these illnesses and their causes, any more than they have anything to explain them. The prophets

give information about hidden matters.”65

Ibn Qayyim suggests, then, that while the concept of

contagion has foundations in physical medicine, it must also be understood as a metaphysical

issue.

Contagion: Disease and Stigma in Infection and Treatment

Ibn Qayyim’s discussion of contagion has two main purposes. In one respect, he seeks to

64

It should be noted that I will later make reference to “stigma” as a subdivision of contagion of the heart. This

stigma is the same as what I have described above, but whereas in this section I discuss “stigma” as a connotation of

the term contagion, my later discussion will elaborate on how that connotation functions within Ibn Qayyim’s theory

of contagion. In that later discussion, however, “stigma” will be referred to as a means of transmitting disease. 65


20

explain how diseases are transmitted from one person to another. To explain transmission, he

turns equally to Prophetic and Classical medicine for support, and addresses two separate means

of disease contraction. His other aim is to deal with a contradiction within Prophetic medicine

that poses a problem for his larger theory of contagion. According to a standard reading of

certain passages from the Qur’an and ḥadīth, Islam seems to deny the existence of disease

transmission. Through his discussion of contagion in Islamic literature, Ibn Qayyim explains the

relationship between physical and metaphysical contagion by showing how plague encompasses

both. Though my analysis of contagion as both a physical and a metaphysical issue focuses

primarily on topics under the purview of Prophetic medicine, Classical medicine continues to

underlie Ibn Qayyim’s work. He explains that “Plague is designated by [two] factors: (1) the

external symptoms as mentioned by the physicians [of Classical medicine]; (2) the resulting

death, and this is the meaning of the sound ḥadīth: ‘Plague is a martyrdom for every Muslim.’”66

Ibn Qayyim’s work knowingly draws on both the Classical and Prophetic medical traditions, but

within the context of plague deals more with the issues of the Prophetic as these reveal more of

Ibn Qayyim’s larger understanding of contagion.

When Ibn Qayyim speaks generally about contagion, he delineates two kinds of

contagious disease, represented by plague and leprosy.67

While these diseases may be understood

as two particular, and perhaps the two most prevalent, contagious diseases, it is also possible that

Ibn Qayyim is using these two diseases as examples of two different means of contagion. Just as

his general theory of medicine is divided into the heart and the body, contagion, as suggested in

the passage above regarding anxiety in the spread of disease, is not only a matter of both the

66

Ibid 67

This discussion is not originally Ibn Qayyim’s but rather is reproduced by him as one of several means of

interpreting the conflicting ḥadīth. As such, Ibn Qayyim sanctions this particular explanation, and there is reason to

believe that this, among all the interpretations he offers, is most in line with the theory he professes throughout at-

Ṭibb an-Nabawī.

21

heart and body, but is actually divided into two types: contagion of the heart and contagion of the

body.68

In this case, plague is an example of contagion of the heart, and leprosy is an example of

contagion of the body.

Contagion of the body, as explained through Ibn Qayyim’s discussion of leprosy,

constitutes diseases transmitted by purely physical means, such as breath or sexual intercourse.

Ibn Qayyim explains that, in coming into contact with lepers, “[Physicians] are not immediately

considering the concept of contagion, but their prime concern here is to prevent the exchange of

breath as it may cause sickness to anyone who inhales it for a long while. Physicians are the

people least likely to believe in good or evil portents.”69

While this passage confusingly seems to

suggest that contagion is not the same thing as the transmission of disease via exchange of bodily

fluids, it actually reveals the distinction between contagion of the body and contagion of the

heart. Ibn Qayyim asserts that the exchange of breath is the means of transmitting leprosy, and so

the reader understands that leprosy can only be contracted by physical contact. In contrast, “evil

portents” and another meaning of the term ‘contagion’ are not responsible for transmitting

leprosy, and so physicians are not concerned with catching the disease since they know that as

long as they do not share breath with the person, there is no other way for them to contract

leprosy. As “evil portents” can be understood to indicate spiritual ills or otherwise non-physical

means of infection, this passage explicitly states that although in general there are two means of

disease transmission, only the physical means, that is, contagion of body, and not the spiritual

68

While the contagions of the heart and body can respectively be characterizes as physical and metaphysical means

of transmission, these should not be conflated with the two medical traditions (Classical and Prophetic). Both

medical traditions deal with both types of transmission. As is apparent in the following section, much of the

discussion of the physical contagion, or contagion of the body, of leprosy comes from ḥadīth, and much of the

discussion of the metaphysical contagion, or contagion of the heart, of plague finds its roots in the Classical tradition. 69

Ibn Qayyim, Medicine of the Prophet, p. 114. Note that while Ibn Qayyim’s evidence for leprosy as a physically

transmitted disease comes from ḥadīth (as is shown further down in the discussion of contradictory ḥadīth), his

understanding of physical contagion by the exchange of bodily humors corresponds to the Classical tradition. The

reference to evil portents here is likely also an implicit reference to the ḥadīth that is the title of this paper.

22

means, contagion of the heart, are viable for leprosy.

Ibn Qayyim further elaborates on leprosy as a contagion of the body by drawing a

parallel to the camel disease, scab. He explains how camels pass scab to one another by secreting

a moisture from open sores and rubbing it against the bodies of healthy camels. In this case, the

physical transmission of disease was apparently common knowledge, and so Ibn Qayyim applied

his understanding of the transmission of the camel skin disease to leprosy. He says of this: “This

is the concept which the Prophet had in mind: ‘A sick person must not be in contact with the one

in good health’. He did not wish the one blighted to mix with the healthy, so that the like of his

trouble should not afflict the healthy one through drops of moisture and scab.”70

Therefore, not

only is leprosy a contagion of the body, but furthermore because it is transmissible by physical

contact, leprous individuals should be kept separate from those not afflicted by the disease. The

ḥadīth Ibn Qayyim reproduces in this passage, then, should be understood to apply only to

contagion of the body, for as his discussion continues, the same rule is not true for contagion of

the heart.71

In contrast to contagion of the body, contagion of the heart is transmissible only through

non-physical means. Ibn Qayyim suggests three kinds of contagion of the heart: illness caused by

the anxiety that one might become sick, illness caused by any of the metaphysical means that

constitute Ibn Qayyim’s notion of the heart, and the stigma associated with a particular disease.

The first kind, similar to modern notions of psychosomatic illness, aligns with Ibn Qayyim’s

earlier statement about fear or anxiety inviting disease; simply by imagining that one can be sick,

or by fearing the possibility of contracting disease from another individual, a person may

70


While leprosy has long been a prime example of stigmatized disease, Ibn Qayyim does not discuss leprosy in this

way.

23

actually become sick.72

The second kind of contagion of the heart, transmission of disease via

metaphysical means, Ibn Qayyim later explains in greater detail as a primary means of

transmission of the plague, and this will be discussed further down.

The third means of contagion of the heart, transmission by means of a stigma associated

with a disease, Ibn Qayyim does not consider to be a valid means of contagion. Ibn Qayyim

explains this phenomenon in terms of plague. He says:

[plague] befalls a town, and then everyone leaves out of fear of contagion. Now the

Prophet had said: ‘If it [plague] occurs in a town while you are there, do not leave the

place; but when plague is in some other town, do not enter there.’ By his words ‘Do not

leave the town where it occurred’ he means it is as if you think that flight from God’s

decree will rescue you from God. And by his words: ‘When it is in a town, do not enter

there’ he means that remaining in the place where there is no plague will calm the hearts,

and will promote confidence and safety. 73

The people who flee from plague escape their concern that they will catch it, rather than escape

the corruption of the air or water that might indicate a physical means of transmission. It is, then,

the stigma of the disease, the fear, anxiety, and other metaphysical notions associated with the

disease, that these people believe will transmit the plague to them.74

Furthermore, God’s decree

not to enter a plague-infested land, Ibn Qayyim claims, is to prevent people from feeling anxious,

not to keep the healthy individuals away from the sick ones. Ibn Qayyim’s concern in preventing

the spread of plague, then, is confined to reducing anxiety, rather than reducing contact as it was

with leprosy. However, Ibn Qayyim does not actually suggest that plague can be contracted in

this way; rather, his discussion here is focused on the ill-advised flight from plague, showing

what contagion of the heart is without actually indicating that plague is transmissible in such a

72

This concept is discussed in Galen’s That the Mental Faculties follow the Bodily Constitution, and may, in fact,

derive from it. 73


Though Ibn Qayyim contextualizes this discussion of anxiety as a means of transmission within the ḥadīth

reproduced above, this idea may also be traced back to Galen. (Arthur J. Brock, Greek Medicine: Being Extracts

Illustrative of Medical Writers from Hippocrates to Galen, (London; J.M. Dent & Sons, LTD., 1929),p. 231.)

24

way.

Further detailing how people can believe that a physical ailment such as plague can be

transmitted by fear and anxiety, Ibn Qayyim explains the concept of contagion of the heart in

terms of misfortune. To this effect, Ibn Qayyim says: “In the same way, if a woman or a house is

known for bringing misfortune, in the event that something unpleasant befalls the husband or

some calamity occurs for the inhabitants, then one would say: It gave me contagion by its

misfortune. It is the kind of ‘contagion’ of which the Messenger of God said: ‘There is no

contagion.’”75

In categorizing contagion of the heart as it relates to plague along with the entirely

non-medical issue of misfortune, this passage deals with two issues of contagion: the first issue is

what contagion actually means outside of a strictly physical context, and the second issue is the

clarification of this alternate meaning of contagion in Arabic literature.

By reporting “it gave me contagion by its misfortune” Ibn Qayyim separates the notion of

contagion from the visceral disgust granted to foul-smelling breath or mucus and instead deals

solely with the phenomenon of the transmission of misfortune or negative emotions (in this case,

the stigma type of contagion of the heart). ‘Contagion’ here is no longer the means of

transmitting disease; it is the metaphysical processes that are often associated with the

transmission of disease. ‘Contagion’ has two aspects in this sense: it is the contraction of disease

by anxiety that Ibn Qayyim previously introduced (and in that capacity it is also a matter of trust

in God), but it is now also the stigma carried by one who suffers from any negative turn of events,

not merely those negative turns of events that concern the physical body. Ibn Qayyim tells his

reader that people perceive an unlucky person to be contagious in their misfortune, and so,

because they are “known for bringing misfortune” they are not simply unlucky in themselves,

but they also pass this misfortune onto others.

75


25

The second issue that this passage raises is the location of this particular understanding of

‘contagion’ within the source material for at-Ṭibb an-Nabawī. At the end of this passage, Ibn

Qayyim asserts that, “[this] is the kind of ‘contagion’ of which the Messenger of God said:

‘There is no contagion.’” As I have already shown, this kind of contagion is the stigma type of

contagion of the heart, which, as Ibn Qayyim elaborated throughout this passage, is not strictly

confined to disease but rather may communicate any form of misfortune by means of negative

emotions. The other kind of contagion, contagion of the body, is distinctly separate and, it seems,

confined to the realm of physical disease. Therefore, Ibn Qayyim explains with this passage that

the ḥadīth that declares ‘there is no contagion’ is not denying the existence of the physical

transmission of disease, but rather is denying the existence of a stigma type of contagion of the

heart associated with a particular phenomenon. Typically, this ḥadīth is employed in the

discussion of plague, and so in that context it should be understood that the ḥadīth denies a

stigma associated with the physical disease that is plague.

When Ibn Qayyim offers plague as an example of contagion of the heart, he actually only

deals with the social reputation of plague as a highly contagious disease and the resulting panic

among the population during an outbreak. Therefore, Ibn Qayyim is only refuting the existence

of contagion of the heart as a stigma. That is, there is no stigma associated with disease or

misfortune that is capable of transmitting that disease to another person. However, the

psychosomatic contraction of disease, especially as an issue of faith, the metaphysical

contraction of disease, and the physical contraction of disease are all still entirely valid means of

disease transmission.

Ḥadīth on Contagion

Ibn Qayyim understands contagion to have the two distinct manifestations of heart and

26

body, and, within that, three distinct means of transmission via the heart; however, such clear

delineations are apparent neither in the medical literature of his time nor the ḥadīth that address

contagion. In particular, the ḥadīth, by not making any distinction between contagions of the

body and heart, appear to disagree on whether or not contagion even exists. Ibn Qayyim,

therefore, uses his theory of contagion, supported by the wisdom of both the Prophetic and

Classical traditions, to elucidate these ḥadīth and create a consistent narrative between them.

Ibn Qayyim presents a contradiction between a number of ḥadīth within the canon of

Arabic medicine, as some suggest that contagion, the communication of disease, is possible and

should be feared, while others seem to say that contagion is not a concern. This contradiction is

most easily seen between the following two ḥadīth: “A sick person must not be in contact with

one in good health;”76

and “There is no contagion, and there is no evil portent.”77

The former

suggests the same principle Ibn Qayyim spelled out in his discussion of leprosy; disease can be

spread by interacting at close proximity, so that should be avoided. The latter appears to say the

opposite; disease cannot be spread, whether by close proximity, or by negative emotions. Yet Ibn

Qayyim assures his reader that “there is no contradiction – by the praise of God – between these

sound ḥadīth.” 78

Although he does not yet explain exactly how it is possible that these

apparently contradictory declarations could, in fact, agree, Ibn Qayyim lays down a stern axiom

on the matter:

Two sound clear ḥadīth, opposed in every way, where one does not abrogate the other,

could never be found. God forbid that such should occur in the speech of one truthful and

trusted, the one from whose mouth naught but truth can ever come. But the defect is from

inadequate knowledge of what is transmitted and the distinction between what part of it is

sound and what is defective, or from incapacity in the understanding of the Prophet’s

intent and attributing to his words a meaning which he did not intend; or from both

reasons together. From this has occurred a great deal of disagreement and harm. Success

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comes from God.79

Here, Ibn Qayyim explains one of the fundamental truths of Prophetic medicine: the word of

God, via the words of the Prophet, must always be right. If they appear to be wrong, it is by

human error. It is with this in mind that Ibn Qayyim’s at-Ṭibb an-Nabawī moves forward to deal

with such outright inconsistency.

By interpreting contagion in two capacities, the heart and the body, Ibn Qayyim enables

his reader to see continuity between two ḥadīth whose instructions more explicitly contradict one

another. While one commands Muslims “[to] flee from the one with leprosy, as you flee from the

lion,”80

the other says: “The Messenger of God took the hand of a man suffering from leprosy,

and he put it with his own into the large food bowl, saying: ‘Eat in the Name of God, trusting in

God, and relying upon Him.”81

While one ḥadīth outlines a scenario of contagion of the body, in

which only the physical threat of leprosy, as suggested by the lion, is offered, the other ḥadīth

displays a situation of contagion of the heart, in which the threat is expressed as a fear of

catching disease, which is allayed by the assurance to trust in God. Therefore, while one ḥadīth

confirms the physical contagion of leprosy, the other does not deny it, and although the second

one recognizes that people might fear the prospect of falling ill, this second ḥadīth discourages

such a fear, implying that trust in God will deliver the pious Muslim. These interpretations are

both consistent with Ibn Qayyim’s previous assertion that although many people flee the plague

because they do not want to contract it, there is no stigmatic contagion of the heart to plague and

so they have nothing to fear.

Contagion of the Heart: Plague and Calamity

This issue of contradictory ḥadīth exists more specifically for the plague, as well, with a

79

Ibid 80



28

number of commonly repeated adages that do not seem to agree on whether plague is contagious

or not. This particular confusion in response to the plague draws attention to Ibn Qayyim’s larger

theory of how contagion of the heart and contagion of the body relate; while Ibn Qayyim has

already offered plague as an example of contagion of the heart to show that the disease does not

carry such a stigma, it is not clear that the ḥadīth that refer to plague agree on this matter.

Arabic medical writings on the plague consistently recall a set of ḥadīth that appear to

deal with the same contradiction as the core ḥadīth on contagion do; Ibn Qayyim, who faithfully

offers every debate on the medical topics discussed within his work, compiles these ḥadīth and

draws attention to their disagreement. The point of contention is most commonly identified

between “The plague is a martyrdom for every Muslim,” and “So if you hear of it occurring in

any land, do not enter there and if it breaks out in any land while you are there do not leave it in

flight.”82

The contradiction here does not directly deal with contagion, but rather it implicitly

requires a certain understanding of disease transmission. The first ḥadīth, in calling plague a

martyrdom, implies that to die of the plague is to die in a struggle for God; this is generally seen

as a positive act and therefore while one ideally should not seek out the plague, one should not

avoid it either. The second ḥadīth, on the other hand, suggests that the plague should be avoided

entirely, implying that those who may have come in contact with it should be isolated from those

who have not.

Apart from the basic disagreement between these two ḥadīth regarding whether or not the

plague should be avoided, there is a discontinuity regarding the nature of the plague as a

contagion: the first ḥadīth implies that it is a contagion of the heart in that it is part of an

emotional struggle for God, while the second ḥadīth implies that it is a contagion of the body in

that it should be physically avoided. The explication of these two ḥadīth requires an

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29

understanding of plague as a contagion of both the heart and the body, an examination of the

second ḥadīth, and a contextualization of these ḥadīth with the concept of calamity.

Ibn Qayyim explains that despite the seeming incongruity of these ḥadīth, they are not

only consistent with one another regarding a medical approach to the plague, but they are also

consistent with the definition of contagion he has already established in a way that has not been

fully discussed. First, Ibn Qayyim encourages his reader, it must be understood that plague has

an element of both contagion of the heart and contagion of the body. Plague challenges the faith

of those who contract it and gives them an opportunity to show themselves as pious to God, but

plague is also a matter of physical corruption, recalling the Classical medicine that is also a

major component of Ibn Qayyim’s perspective. To this end, Ibn Qayyim explains that plague is

contracted in two ways: in the first way,

God, praised be He, can give to these spirits power over the bodies of the sons of Adam,

during the occurrence of infection and through corruption of the air… Now the satanic

spirits have a power of working upon the person who is affected by these conditions in a

way which they cannot regarding others. Their power continues so long as they are not

repelled by some defence [sic] stronger than their causes, such as dhikr and prayer,

supplication and entreaty, almsgiving and recitation of the Qur’an. These deeds will

invoke the angelic spirits who can conquer the evil spirits, make void their evil and repel

their influence… When God, the Exalted, wishes to put His decree and command into

effect, He causes the heart of the servant to neglect knowledge of these angelic spirits and

to cease to imagine or seek them. Thus he is not aware of them and does not want them,

so that God may accomplish in him some deed already decreed.”83

Therefore, in terms of contagion of the heart, plague is the expression of a test or show of power

sent by God in which the afflicted individual is subjected to the anxiety of disease in the form of

jinn and other malignant spirits, which makes the afflicted unable to be aware of the feelings of

calm in the form of angels. This, of course, remains consistent both with Ibn Qayyim’s beliefs

about the existence of ‘psychosomatic’ and faith-related contagion of the heart, without bridging

into the territory of the metaphysical stigma of contagion of the heart, which Ibn Qayyim has

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30

previously said is not sanctioned by Islam.

However, plague is also a contagion of the body, and very much a physical disease. Ibn

Qayyim explains that the ḥadīth even identify the disease specifically by its physical elements:

“Ta’un is the swelling of a gland like that of the camel, which affects the soft places and the

armpit.”84

Therefore, it is not simply Ibn Qayyim’s observations, nor his roots in Classical

medicine,85

that lead him to see plague as a contagion of the body, but the Islamic literature even

explicitly catalogues it as such. Ibn Qayyim elaborates on this point to explain how the physical

ailment is contracted. He says, “[ṭā’ūn] is used specifically to describe the inflammation that

occurs in the glandular flesh; and because of its malignancy only organs that are weak by nature

accept it. The worst kind is that which occurs in the armpit and behind the ear, because these

places are near to the principal organs. The least harmful are the red inflammations, then the

yellow; while the black allows no one to escape.”86

Therefore, plague as a contagion of the body

is the result of organs with a weak constitution, which become inflamed. In addition to this, Ibn

Qayyim says that it is a disease caused by the corruption or poisoning of blood, which, as he

detailed earlier in his work, can be caused by any number of external influences. 87

It seems that

this would include transmission via bodily fluids, as he described it in context of contagion of the

body.

While recognition that plague is both a contagion of the heart and of the body is

necessary for understanding how the two ḥadīth agree, Ibn Qayyim explains that deeper

knowledge of what is meant by the ḥadīth that appears to discuss quarantine is necessary for the

84


Ibn Qayyim also discusses plague in terms of Classical medicine, explaining, for instance, that “it is caused by

bad blood which tends to putrefaction and corruption, and transforms into a poisonous substance.” (Ibn Qayyim,

Medicine of the Prophet, p. 27) This discussion continues throughout his chapter on plague. 86



31

two ḥadīth truly to be consistent. The obfuscation of this second ḥadīth, which councils the pious

Muslim neither to enter nor leave a plague-afflicted territory, comes in the somewhat unexpected

meaning of the second part. The first part of this ḥadīth does indeed prohibit entering a place

where plague is active to prevent contraction of the disease: “For in entering a land where it is

present, one is exposing oneself to the danger of being affected through communication with the

plague in the very land where it is most powerful, and thus acting against one’s own interests.” 88

This prohibition is specifically designed, Ibn Qayyim says, to “protect ourselves from harmful

airs and places.” 89

In contrast, the restriction against leaving a plague-infested area is not designed to

contain the contagion, but rather both to retain the health of the trapped individual and to express

that individual’s devotion to God. The former claim is easily explained: “as the authorities in

medicine have said, everyone who takes precautions against pestilence must expel from his body

the superfluous moistures, must take little food, and incline towards a drying regime in every

way except for exercise and bath, for these two should be avoided.” 90

Therefore, one who

suspects that he has come into contact with plague should not move a great deal, so as to

encourage the physical element of the disease to leave his body. The latter claim, however, is

somewhat more elusive, as it deals with the aspect of plague that is contagion of the heart. Ibn

Qayyim says: “this prohibition brings one to have complete trust and confidence in God and to

endure patience and accept with contentment His decrees.” 91

The prohibition against leaving,

then, is, in part, a test of God’s power over the faithful: a rule for the sake of a rule. While this

explanation does explain the ḥadīth in terms of an effort to please God, thereby creating some

88


Ibid 90


Ibid

32

association with the basic concept of martyrdom, it is still unclear exactly how the two ḥadīth

agree or even are relevant.

The link between the decree against leaving for the sake of God’s decree and the ḥadīth

on martyrdom is a particular understanding of faith that underlies contagion of the heart: the

benefits of calamity.92

While calamity is not perceived as an inherently good affliction, Ibn

Qayyim explains that the purity of one’s faith is revealed in times of misfortune, and so calamity

is a chance for a Muslim to demonstrate the extent of his faith. Ibn Qayyim relates that “The

Most High said: Give glad tidings to those who patiently persevere, those who say, when

afflicted with calamity: To God we belong, and to Him is our return. They are those on whom

descend blessings from God, and mercy, and they are the rightly guided (II:155-57).”93

This

ḥadīth reveals that God favors those Muslims who not only bear their ill fortune gracefully, but

especially those who keep in perspective that the physical world is temporary and that regardless

of how or when they die, God will receive them once their earthly lives end.94

Not only is the

physical world impermanent, but the souls of the people themselves are borrowed from God.

When those souls return, they will not have any vestiges of their physical lives, only their good

and bad deeds.95

Therefore, the good Muslim faces disaster not with the intention to survive, but

rather with the intention to keep his soul pure.

Furthermore, Ibn Qayyim tells his reader, all Muslims should understand that calamity is

not random; it is planned and sent by God, and so a Muslim should realize that worry over it will

92

Anna Akasoy’s article, "Islamic Attitudes to Disasters in the Middle Ages: A Comparison of Earthquakes and

Plagues." (The Medieval History Journal, Vol. 10, no. 1&2 (2007), pp, 387-410.) explains in greater detail how

reactions to plague and calamity (in the case of the article, earthquakes) are guided by the same principle of

maintaining the goodness of the soul. 93


“He is not the one who brought this into existence out of nothingness, making it really his possession; nor is he the

one who preserves it from disasters once it does exist; nor does he cause its existence to continue. Throughout he has

neither influence nor real ownership.” (Ibn Qayyim, Medicine of the Prophet, p. 142) 95


33

not alter his fate.

Part of the treatment for such disasters is that one should know that anxiety cannot turn

them away, but will multiply them; and in truth it only increases the sickness.

Furthermore, as to their treatment one should know that losing the reward of patience and

submission – which is the blessing and mercy and guidance that God warranted for

patience and resignation – is truly greater than the disaster.96

This is not merely a reassurance that all things are meant to be. This knowledge, Ibn Qayyim

says, is instrumental to the treatment of affliction. The affliction here is a contagion of the heart,

a psychological and emotional sickness that causes the afflicted both to fear the consequences of

the physical world and to doubt in God. By focusing on this element of disease, Ibn Qayyim is

stressing the fact that the results in the physical world, though he is concerned with those to some

degree, are not especially important. He is concerned primarily with maintaining the peace and

purity of the soul, and that, he assures his reader, is to be done by trusting in God.

With the understanding from this discussion of calamity, it is apparent that while plague

is also a contagion of the body, it is most importantly a contagion of the heart. The prohibition

against leaving a plague-afflicted place is a way of expressing calm and assurance, showing to

God an awareness that the physical world is not important because it is temporary. Furthermore,

plague is a martyrdom because death of plague is death of a misfortune sent by God; therefore, it

is death in a struggle for God. Such compliance, Ibn Qayyim says, means overcoming the much

more serious condition of contagion of the heart. This is because “restoration of the body without

restoration of the heart is of no benefit, whereas damage to the body while the spirit is restored

brings limited harm, for it is a temporary damage which will be followed by a permanent and

complete cure.”97

Ibn Qayyim’s treatment of contagion professes that despite a fairly balanced approach to

96



34

medicine, employing traditions that deal both with the physical body and the metaphysical faith,

the primary concern for a physician of at-Ṭibb an-Nabawī is the metaphysical health of an

individual. Although this idea appears to prefer metaphysical over physical medicine, Ibn

Qayyim explains that

‘For every disease there is a remedy’, [and this should] be taken in a general sense, so as

to encompass fatal illnesses and those which no physician can cure. In that case, God the

Most Glorious has appointed remedies to cure them but has concealed the knowledge of

such remedies from humankind, and has not given man the means to find out. For created

beings have no knowledge except that which God has taught them.98

Here, despite Ibn Qayyim’s concern for illness and wellness of all kinds, he recognizes the

limitations of his knowledge; there are simply some things that he cannot understand. The plague,

for instance, is beyond his comprehension; its cause and exact means of physical transmission

cannot be determined. In many ways, most physical contagion is equally elusive, for the exact

mechanism cannot be specified. This, for Ibn Qayyim, must be the work of God, who has not

revealed enough knowledge to humans. But if every disease has a cure, and the physical world is

temporary, then all a physician can hope to do is cure what is permanent: the heart. The

metaphysical does not take precedence over the physical; rather it fills in the gaps in the

knowledge that has not yet been obtained.

Therefore, Ibn Qayyim’s theory of contagion employs metaphysical (heart) and physical

(body) contagion in tandem to create a holistic approach to dealing with transmissible diseases.

Contagious diseases, within this theory, transmit between people by physical bodily proximity

and the exchange of humors therein, or by anxiety or a lack of faith in the heart that God will

preserve the health of His people. Plague, as a calamity, is transmitted via both heart and body.

In understanding plague and contagion within these two capacities, Ibn Qayyim has produced a

flexible theory, in which either capacity may be minimized or discarded, allowing for the best

98


35

possible understanding of a given contagion. This flexibility suggests that there are contexts in

which contagion is not a strictly medical concept.

As Ibn Qayyim has already shown in his use of ḥadīth, particularly those that address

calamity, metaphysical (heart) contagion is an issue of faith in the face of disaster, which Ibn

Qayyim draws into a medical discussion. This inclusion blurs the division between medicine and

religion. Furthermore, Ibn Qayyim’s notion of psychosomatic contagion has roots in classical

discussions of the relationship between the mind and body,99

which in themselves can be

considered either medical or philosophical. In both these instances, the contagion Ibn Qayyim

discusses is not an inherently medical issue, but rather an issue that was originally perceived in

the context of a different field and was imported into medicine because of its applicability. Ibn

Qayyim’s theory of contagion can be seen performing this process again, by associating the two

medical theories, Prophetic and Classical medicine, as well as two means of contagion, heart and

body, within the context of plague. He draws these theories together in order to apply the

wisdom of these seemingly separate notions to a catastrophe that pervaded society, and therefore

was not simply a medical issue.

Part II: Ibn al-Wardi, a Practical Assessment of Theories on Plague

For all the broad applicability and innovation of Ibn Qayyim’s theory of contagion, it is

not apparent that Ibn Qayyim was able to apply this theory in any way, or develop it further

beyond a scholarly debate. Though his descriptions of plague do suggest that he witnessed

scattered cases of the disease, it is not apparent that he experienced the pandemic of the Black

Death, and so Ibn Qayyim was likely unable to examine the validity of his theory in action. It is

for this reason that I return to Ibn al-Wardi, who dutifully recorded his experience witnessing the

spread of the pandemic. Though Ibn al-Wardi was neither a medical practitioner nor theorist, his

99

As in Galen’s That the Mental Faculties follow the Bodily Constitution in Brock, Greek Medicine, pp. 231-244.

36

discussion of the plague reveals a certain understanding of contagion that is consistent with Ibn

Qayyim’s theory. Ibn al-Wardi’s use of this theory is a testament to its applicability, an exhibit of

the theory being taken out of the lab and tested in the field.

Little is known about Ibn al-Wardi, though he wrote extensively in his time. Zayn ad-Dīn

Abū Ḥafṣ ʿUmar b. Muẓaffar b. ʿUmar b. Abi ’l-Fawāris muḥ b. ʿAlī al-Wardī al-Ḳuras h ī al-

Bakrī al-S h āfiʿī S h āfiʿī faḳīh was born in 689 or 691/1290-2 in Maʿarrat an-Nuʿmān, near

Aleppo. He was educated extensively, composing works on philology, history, and poetry. He

served as the deputy to the ḳāḍī of Aleppo for a short time, but gave up the position to pursue

literature.

Ibn al-Wardi’s Risāla is collected in a larger diwan, and is also referenced in his

Tārīkh.100

The work itself is composed in rhyming prose and largely tells of the plague in Aleppo

from 746/1346 to 749/1349, when Ibn al-Wardi died of plague.101

This prose is very poetic and

dramatic in its description of the disease, but throughout it Ibn al-Wardi continues to employ an

understanding of plague both as a deadly, albeit less important, physical contagion, and as a

metaphysical contagion of the utmost significance.

Ibn al-Wardi discusses plague first as a physical contagion. Similar to Ibn Qayyim’s

belief that plague, among other contagious diseases, could be spread via corrupted air,102

Ibn al-

Wardi says, “Oh Plague, Hamah is one of the best lands, one of the mightiest fortresses. /Would

that you had not breathed her air and poisoned her, kissing her and holding her in your

embrace.”103

Though pieces of this passage are purely decorative, the association of air with the

100

Moh. Ben Cheneb. "Ibn al-Wardī." Encyclopedia of Islam, Second Edition. , 2012. Reference. Carleton College.

24 February 2012 http://referenceworks.brillonline.com/entries/encyclopaedia-of-islam-2/ibn-al-wardi-SIM_3407. 101

Dols, “Ibn al-Wardi” p. 445. 102

“Also the breath of the sick person may reach the healthy one and cause him to fall sick. This can be clearly seen

in the case of some illnesses. Breath is one of the means of contagion.” (Ibn Qayyim, Medicine of the Prophet, p.

112) 103

Ibn al-Wardi, Risāla, p. 451.

http://referenceworks.brillonline.com/entries/encyclopaedia-of-islam-2/ibn-al-wardi-SIM_3407

37

disease, the particular imagery of an unseen force emitting poison into the air, suggests a belief

that the plague may have been spread by something bad in the air. This sentiment is reinforced in

Ibn al-Wardi’s mention of the corpses of plague victims. Ibn al-Wardi advises that no one go

near those people who may have died from plague or come into contact with plague corpses,

cautioning, “If you see many biers and their carriers and hear in every quarter of Aleppo the

announcements of death and cries, you run from them and refuse to stay with them.104

” It is

implied here that proximity to plague will transmit it, though not how exactly.105

In terms of physical treatment of the plague, Ibn al-Wardi describes a regimen that

corresponds to Ibn Qayyim’s recommendations for treatment of plague. Ibn al-Wardi relates the

following treatments for plague’s physical effects:

Oh, if you could see the nobles of Aleppo studying their inscrutable books of medicine.

They multiply its remedies by eating dried and sour foods. The buboes which disturb

men’s healthy lives are smeared the Armenian clay. Each man treated his humours and

made his life more comfortable. They perfumed their homes with ambergris and camphor,

cyperus and sandal. They wore ruby rings and put onions, vinegar, and sardines together

with the daily meal. They ate less broth and fruit but ate the citron and similar things.106

This passage reveals a regimen based around foods that were believed to be drying, inhaling

perfumes that would cleanse the air to soothe the skin and remove phlegm, and balms that would

reduce the inflamed buboes. Each of these directly corresponds to Ibn Qayyim’s general theory

of treatment for plague, and even his specific recommendations.107

However, Ibn al-Wardi himself does not seem to believe that these treatments worked.

The opening line of this passage is almost sarcastic in tone, suggesting that while the physicians

and nobles believed that their medicine was inscrutable, it had little effect on who lived or died.

104

Ibn al-Wardi, Risāla, p .453. 105

This, too, is similar to Ibn Qayyim’s theory, which also understands that physical contagion, contagion of the

body, finds agency in proximity. “A sick person must not be in contact with one in good health.” (Ibn Qayyim,

Medicine of the Prophet, p. 112) 106

Ibn al-Wardi, Risāla, pp. 452-3. 107

For instance, Ambergris: It is beneficial for… illnesses caused by phlegm. (Ibn Qayyim, Medicine of the Prophet,

p. 244)

38

Furthermore, Ibn al-Wardi’s description of how “each man treated his humours and made his life

more comfortable” suggests that the treatments helped the body to some degree, but they could

not conquer the disease, which, as its anthropomorphic characterization previously suggests, was

a force unto itself that was beyond human action. Though this derides physical medicine, it

echoes Ibn Qayyim’s frustration with the limitations to physical medicine’s ability to deal with

contagious diseases.108

Just as Ibn al-Wardi works within the same theory of physical medicine as Ibn Qayyim,

Ibn al-Wardi’s discussion of the metaphysical aspects of the plague correspond to Ibn Qayyim’s

concept of ‘contagion of the heart’. Ibn al-Wardi says, “I saw the town of Ma’arrah, like an eye

adorned with blackness, but its eyebrow decorated with oppression. /What could the plague do in

a country where every day in its tyranny is a plague?109

” Here he employs a dual use of the term

‘plague’ that links the physical disease to the metaphysical torment.110

On the one hand, the

plague is the name of the disease that is very physical and has obvious symptoms and causes real

damage. On the other hand, the plague is also the suffering, the calamity that befalls those who

experience the disease. The plague goes beyond the disease; the ailment is more than physical.

This understanding is very much in line with Ibn Qayyim’s explanation of the plague as both a

contagion of the body, wherein it is a mysterious deadly phenomenon, and as a contagion of the

heart, a trial of the spirit.

It is within this notion of the plague as a metaphysical force that Ibn al-Wardi devotes his

chronicle to calling on God, pressing the point that the disease and its suffering comes from God

and so can only be removed by God. Ibn al-Wardi cries, “Oh God, it is acting by Your command.

108

“The physicians have nothing whereby to repel these illnesses and their causes, any more than they have anything

to explain them. The prophets give information about hidden matters.” (Ibn Qayyim, Medicine of the Prophet, p. 28) 109

Ibn al-Wardi, Risāla, p. 451. 110

I was not able to obtain an Arabic text of this work, so I do not know which words here were translated as

“plague.”

39

Lift this from us. It happens where You wish; keep the plague from us. Who will defend us

against this horror other than You the Almighty?111

” If the disease can only be brought on by

God, then God must have a reason for it. Since the disease is more than a disease, it is an

experience of suffering, Ibn al-Wardi suggests that it must be a punishment on the people who

have displeased God in some way. Reflecting this, Ibn al-Wardi calls for relief:

We ask God’s forgiveness for our souls’ bad inclination; the plague is surely part of His

punishment. We take refuge from His wrath in His pleasure and from His chastisement in

His restoring. They said: the air’s corruption kills. I said: the love of corruption kills.

How many sins and how many offenses does the crier call our attention to.112

It would appear, then, that Ibn al-Wardi believes that the physical disease of the plague is a form

of punishment sent by God for the corruption of society, and that deliverance comes in fervent

worship of God.

Though Ibn al-Wardi sees the plague as a punishment, it is also “a martyrdom113

and a

reward.” More accurately, these two capacities show that the plague is a test sent by God.

Although the plague itself causes suffering, its purpose is not to induce pain, but rather to offer

the human soul the chance to act according to God’s will. This notion is likely founded in the

ḥadīth discussed by Ibn Qayyim: “The plague is a martyrdom for every Muslim.”114

Ibn al-

Wardi explains:

The dwellers of Sis are happy with what afflicts us, and this is what you can expect from

the enemies of the true religion.

God will spread it to them soon so that He will put plague upon plague.115

The plague is for Muslims a martyrdom and a reward, and for the disbelievers a

punishment and a rebuke. When the Muslim endures misfortune, then patience is his

worship. It has been established by our Prophet, God bless him and give him peace, that

111



Martyrdom in Islam is defined as death in a struggle for God. There is no expectation of suffering; rather, this

struggle can be any effort to perform the will of God. 114


Here, again, Ibn al-Wardi uses a dual meaning of the term “plague,” with the first instance indicating the disease

and the second indicating the scourge that is non-Islamic religion. However, as this is in translation, it is not clear

that the Arabic uses this play on words.

40

the plague-stricken are martyrs. This noble tradition is true and assures martyrdom. And

this secret should be pleasing to the true believer. If someone says it causes infection and

destruction,116

say: God creates and recreates. If the liar disputes the matter of infection

and tries to find an explanation, I say that the Prophet, on him be peace, said: who

infected the first? If we acknowledge the plague’s devastation of the people, it is the will

of the Chosen Doer. So it happened again and again.117

This passage addresses two main themes within both Ibn al-Wardi and Ibn Qayyim’s

understandings of plague and contagion: it shows how plague is both a punishment for those who

do not follow the Muslim conception of God and a martyrdom for those who do, and it explains

the relationship between contagion of the heart and contagion of the body as Ibn al-Wardi

understands it. These themes reveal a dissonance between Ibn al-Wardi and Ibn Qayyim that lies

not in their understanding of contagion, but rather in their respective applications of that

understanding.

This passage explains first that anyone can experience plague, but its purpose is different

for different groups of people. The people of Sis see the plague as a punishment, Ibn al-Wardi

suggests, because for them it is. Non-Muslims can only receive plague as a sign from God that

their religion is false, because the plague itself is God’s tool for testing faith. Since the people of

Sis do not believe in God, they could never be delivered from suffering by Him, so they cannot

overcome the disease through faith. Muslims, on the other hand, have been instructed on what to

do during a plague, and so if they have faith in God, their suffering will end by following the

prescriptions. This concept resonates with Ibn Qayyim’s decree for the sake of a decree.118

Conversely, Muslims who die of the plague can be martyrs if they die following God’s

decrees. Islam understands martyrs to be those who die in the course of any struggle in the name

116

The association of infection and destruction in this section indicates the contagion of the heart meaning of

infection. That is, Ibn al-Wardi clearly does not deny the physical transmission of disease, as we saw before. Rather,

he refutes the belief in the transmission of plague by stigma, as ultimately the disease must be traced back to God,

and God has no use for stigma. Contagion of the heart is a personal issue between the infected and God, so stigmatic

contagion has no use for God. 117



41

of God. Therefore, those who experience plague are committed in a struggle for God, an

expression of their faith through the hardship of bodily suffering. If their “patience is his worship”

then success in the struggle is to bear the disease gracefully, trust that God will do with them

what is right, and wait until they either die or recover. In this case, it is not the result that

indicates success, it is the means. One can die and still be in God’s favor, as in dying he becomes

a martyr. But if a person lives and did not trust that God would take care of him, then he has

failed the struggle in God’s eyes and his soul is doomed.

Ibn al-Wardi’s discussion also shows how, although the plague is both a physical and

metaphysical disease, it is only a significant concern as a metaphysical test of faith. Ibn al-Wardi

suggests that if living and dying from the plague are irrelevant to God’s will, then the material

aspect of the disease is not really significant. God’s concern is the state of the human soul. “He

creates and recreates” the bodies of humans so they may exist in the physical world. Once they

do, their souls are out of God’s direct influence, and so He must use trials such as plague in order

to influence proper belief and worship. Therefore, the physical element of the plague is only a

tool for this test, as the pain of the physical disease encourages humans to seek out faith in God.

Because the physical aspect of the disease is not important compared to its metaphysical

purpose, those who attempt to explain the disease’s physical aspects will be confounded by the

issue of transmission. As a test of faith, the plague is a personal matter between an individual and

God, and so it does not jump randomly from one individual to another, but rather God

intentionally chooses who becomes sick and who does not. This does not refute a theory of

physical transmission, since Ibn Qayyim has explained that one must be predisposed in order to

contract disease, and so predisposal could be determined by God based on whom he wishes to

test. Rather, the issue is with the first instance of infection. If one can only contract plague by

42

contagion from another person, then physical medicine has no explanation for how the first case

of the disease arose. This first case, then, must be God’s will, according to Ibn al-Wardi.

Ibn al-Wardi’s use of the theory of contagion shows how the physical disease and the

metaphysical issues that surround the disease were intertwined when taken in context of the

plague itself. Where Ibn Qayyim merely postulates about contagion as a medical concept, with

plague as an example, Ibn al-Wardi applies the anger, confusion, and hope of one in the midst of

a catastrophe to Ibn Qayyim’s medical concept and shifts the relative importance of its elements.

Ibn Qayyim understood contagion of the heart and contagion of the body to be two equal

elements within the larger concept of contagion because they each supplied a part that completed

the theory. To Ibn al-Wardi, however, while contagion of the body did explain the simple means

of transmission, it did not prescribe a successful treatment. The bodily comfort that physical

medicine supplied did not ease the pain of dying, nor the fear of contraction. Contagion of the

heart, however, explained both why the plague spread and how one could counteract it.

Therefore, Ibn al-Wardi’s understanding of contagion can be seen as an application of Ibn

Qayyim’s theory.

Within this application, the physical contagion becomes less important to treatment, but it

continues to underlie an understanding of the plague itself. The elevation of metaphysical

contagion to greater importance emphasizes the way in which Ibn al-Wardi was more concerned

with the larger effects of the plague beyond physical death: the toll the disease took on society,

the fear of the people, and the religious issues it raised. In this way, Ibn al-Wardi’s application of

Ibn Qayyim’s theory fulfills the purpose of the theory with great success, as the two facets of

contagion are worked in tandem to explain the plague in the way most useful to the situation. In

this case, that use was to understand the plague beyond its identity as a problem of physical

43

medicine, rather to understand it as a larger problem of the society and culture it upon which it

preyed.

Conclusion: Contagion and the Pervasiveness Plague in Medieval Arabic Society and Culture

Because of the different approaches and perspectives of Ibn Qayyim and Ibn al-Wardi, it

is significant for a modern understanding of medieval Arabic medicine and that both authors saw

contagion as a concept that encompassed both physical and metaphysical disease, and that was

derived from a conglomeration of Prophetic medicine and Classical medicine. That both authors

held this view, despite their different backgrounds, suggests that this hybrid perspective was

considered a viable approach to understanding disease within the medieval Arabic scholarly

community. This theory, in itself, nuances a modern understanding of medieval notions of

medicine, because it broadens the definition of what is considered medical. By associating

physical disease and the metaphysical issues of fear, anxiety, social stigma, and religious

repercussion, this theory not only validates all of these as medical issues within the medieval

world, it also breaks down the disciplinary divisions modern historians typically assemble

around them.

While modern historians, such as Dols, Stearns, Pormann, and Savage-Smith, have had

difficulty understanding medieval Arabic medicine as simultaneously encompassing physical

and metaphysical issues, Ibn al-Wardi and Ibn Qayyim illustrate that removing or ignoring either

element from their understanding of medicine results in an incomplete and ultimately unsound

theory. Physical and metaphysical medicine must work together because each one is insufficient

on its own to explain disease fully.119

Indeed, when Ibn al-Wardi discusses plague he must

119

As with Ibn Qayyim’s elucidation of ḥadīth, for example, although the medical discussion within ḥadīth is

framed as an issue of religious repercussions, making it a subset of metaphysical contagion, the conflicting passages

44

advocate for the setting aside of the physical aspect of this medical theory in order to gain the

proper perspective on plague. When Ibn al-Wardi derides contagion of the body as a means of

understanding plague, he does not say that an understanding of the plague as a physical disease is

illegitimate, but rather he believes that for the specific purpose of protecting the soul, the

physical aspects of the disease are irrelevant. By dividing this theory along the lines of modern

notions of religion and science, modern historians have unintentionally dismantled an internally

consistent work. The ultimate proof of this is the confusion caused by the ḥadīth “there is no

contagion, there is no evil portent.” As a religious phrase, modern historians have seen this as the

bald denial of a plainly observable fact. However, if seen in the light of a theory that does not

isolate religion from science, this declaration actually states the logical conclusion that one

cannot contract disease merely by associating with a bad or unlucky individual.

Given the integral importance of metaphysical contagion as a means of dealing with the

social issues of plague and contagion within this theory, it is significant to note that in the

development of the Classical and Prophetic traditions, the plague was not inherently a subject of

medical discussion. Rather, plague is imported into medical debate via the Prophetic medical

tradition, because it, as a phenomenon, is canonized in the ḥadīth literature itself. Similarly,

though there are Classical sources that may discuss the plague,120

the Classical medical tradition

itself is not primarily concerned with the disease, or contagion as a concept.121

Plague did not

begin as an issue of medicine within either tradition, but rather as a subject of discussion outside

of medicine that came to be understood as medical. That plague was not initially a subject of

could not be untangled without employing a discussion of physical contagion. Similarly, though Ibn al-Wardi chose

to focus on the fear, anxiety, and religious issues of the plague, his manner of discussing the disease relied on the

vocabulary and logic of physical medicine. 120

Thucydides’s work on the Peloponnesian War is an oft-cited example of this, as one of the most famous accounts

of the Plague of Justinian, by Procopius of Caesaria, is believed to draw heavily from it. 121

Except for Hippocrates’s “Epidemics.”

45

medical debate suggests that in the wake of the first plague pandemic scholars were focused

more on understanding plague in terms of the multifarious ways it had affected their society and

culture, and that its particulars as a disease were less relevant.

That medieval thinkers first located plague within its socio-cultural implications recalls

the difficulty that modern scholars have had with viewing plague outside of a religious context. It

is likely because of our familiarity with modern notions of what is considered medicine that

recent historians have examined contagion either as a religious issue or as a physical issue, but

not both. Since modern medicine regards religion as irrelevant in most situations, and even

backwards, scholars such as Dols and Stearns, who have focused on this aspect of medieval

Arabic medical theory, have easily distanced themselves from the medieval perspective,

attributing much of its seemingly illogical conclusions to a culture that is irreparably foreign.

When historians such as Pormann and Savage-Smith look at medieval Arabic medicine largely

for its foundations in physical medicine, particularly as a continuation of Classical theory, they

see the makings of modern medicine, and so are inclined to ignore the religious aspects for the

same irrationality that Dols and Stearns focus on them.

By taking into account the many aspects of the human experience that concern disease,

medieval Arabic medicine constructs a complete understanding of contagion, offering a window

into the larger issue of a medieval understanding of medicine. It recognizes that disease is not

just the unseen corruption that infects a body, but it is also the anxiety that wears on the people,

the fear of death, the social stigma of being sick, and the religious implications of becoming

afflicted with a condition that appears to be a form of demonic punishment. To deal only with the

physical aspects of disease would not serve any practical use when the disease permeates the

society in all these other ways. Rather than expound on the specific type of corruption that might

46

have caused the plague, medieval Arabic medicine sought for a practical explanation that might

help to quell the fear and anxiety of the people and thus allow further development of physical

medical treatment.

47

Appendix A: Ibn Qayyim’s theory of disease and contagion

This schematic outlines

the different types of

medicine within Ibn

Qayyim’s at-Ṭibb an-

Nabawī. Medicine is

divided into heart and

body, which, though

separate, are inherently

linked. Those types of

medicine listed below

these are outlined

explicitly by Ibn Qayyim.

The items listed above

these are contagions,

which, like medicine, are

divided into heart and

body; however, Ibn

Qayyim does not directly

define these.

This schematic is meant

to illustrate how Ibn

Qayyim’s theory

distinguishes issues of the

heart (metaphysical) and

the body (physical).

Though the two aspects

are distinguished here,

they are incorporated

throughout his discussion.

heart body

Treatment for

uncertainty/ doubt

Treatment for

desire/ temptation

Goals of

the

Physician

Treatment

by disease

type

Types of

Medicine

Methods of

Treatment

Preservation

of health3

Expulsion of

harmful

substances5

Protection

from Harm6

General

Illness

Illness of

Organs

Similar Organic

Undamaged (departure from

norm)Damaged

combination

NaturalDivine

Treatment by

Similarities

Treatment by

Opposites

Material presentation

(secretion)

Qualitative Presentation

(appearance of condition)

Contraction by

psychosomatic

means

Contraction by

metaphysical

means

Contraction by

stigma

Physical disease

contraction

Contagion of the Heart

Contagion of the Body

Medicine of the Body

Medicine of the Heart

48

Appendix B: Common Ailments and Treatments in Ibn Qayyim’s at-Ṭibb an-Nabawī

Ail

men

ts

Symptoms

Fever, Itching, Pustules, Inflammation, Abscesses

Diseases

Plague, Dropsy, Smallpox, Leprosy, Consumption, Hectic Fever, Scab

Conditions/

Disorders

Diarrhea, Wounds, Epilepsy, Sciatica, Constipation, Pleuresy, Headache, Fauces,

Lice

Tre

atm

ents

Balances/

Cleans

Honey, Camel Milk, Papyrus Ashes, Vinegar (in conjunction with others), Cupping,

Tail Fat (from Arabian Sheep), Dates, Silk, Aloe, Sea Cactus, Henna

Heals/

Removes

or fights

illness

Honey

This chart organizes various ailments and treatments Ibn Qayyim refers to throughout the first

half of at-Ṭibb an-Nabawī. Though it is not within the scope of this paper, this chart illustrates

the important distinction between what Ibn Qayyim considers to be a disease, a symptom, and a

condition. That is, a disease is an unnatural state of the body, whereas a condition is a state in

which the body’s humors are imbalanced, though this may be the natural state for a certain body.

A symptom is an expression of any disease or condition, but it is not itself a disease or condition.

Fever, since it is so broadly defined, is the exception.

The treatments outlined here reveal that, within Ibn Qayyim’s medical theory, there are few

cures. Health is typically achieved by correcting an imbalance, not by removing a particular

corrupting foreign substance. In fact, this theory suggests that once the foreign substance is

removed, the patient needs only to be encouraged back to health by correcting their imbalances.

Since there is no notion of germs within this theory, the corrupting substance is typically

conceived of as fairly large and perceptible, such as a grain of sand in the eye, or foul water that

has been ingested. Both the treatments and the ailments respond primarily to Classical theories

of humoral balance, and many of the treatments are derived from pre-Islamic Arabic folk

medicine.

It should be noted that causes of disease are missing from this chart because, for the most part,

Ibn Qayyim attributed diseases to corrupted substances, but rarely pointed to specific agents that

had carried disease to a human.

49

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