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Ayatollah Sayyid Mahmoud Hashemi Shahroudi, the powerful Chief Justice of the Islamic Republic of Iran from 1999 to 2009 and one of the potential successors of the Supreme Leader, died of cancer in December 2018. After his death, his son revealed that the ayatollah had delayed the cancer treatments recommended by his doctors because he had trusted “Islamic medicine” to cure his disease. As a result, when he finally decided to use “western” medicine, it was too late, and the cancer had already metastasized extensively.

Ayatollah Shahroudi was not alone in his faith in Islamic medicine. Many other high-ranked Shi’a scholars avidly support it to be a part of the biopolitical agenda of the Islamic government. In contrast, others argue that medicine is an independent discipline and cannot be derived from religious scripture.

Religious Biopolitics and Islamic Medicine in Iran

In February 2019, a video went viral on Iranian social media featuring a prominent Shi’a cleric burning a copy of Harrison’s Principles of Internal Medicine. That cleric was Ayatollah Abbas Tabrizian, known to his followers as “the father of Islamic medicine.” By burning that medical textbook, he intended to symbolically declare war against what he refers to as “colonialist, western, and chemical medicine.” Instead, he promotes what he calls Islamic medicine.

Born in 1962 in Najaf, Iraq, Tabrizian is a high-ranked Shi’a cleric (an ayatollah) and a graduate of major Shi’a seminaries. Although he is currently the most prominent figure in Islamic medicine in Iran, he is not alone in supporting Islamic medicine; other prominent ayatollahs have asserted their different degrees of support for it.

Islamic Science

The founder of the Islamic Republic of Iran, Ayatollah Khomeini, once stated that “Fiqh (or Shari’a) is a comprehensive plan for human life from the cradle to the grave!” The Islamic Republic, over the past 45 years, has attempted to base its politics, economics, and social policies on the Shi’a version of Islamic Shari’a. Many Shi’a scholars wonder why not medicine.

Developing “Islamic” science, including Islamic medicine, has been a big part of the Islamization agenda for a powerful group of Shi’a scholars since the establishment of the Islamic Republic in Iran. For example, Ayatollah Sayyid Mohammad Mendi Mir Bagheri, the head of the “Islamic Sciences Academy of Qom,” and an influential figure and a potential (but not likely) future successor of the supreme leader, is an advocate of creating Islamic science, even Islamic physics, chemistry, and of course, medicine. Powerful figures like him are the faces of a branch of Islamic biopolitics in Iran that promotes the development of Islamic medicine.

Islamic Medicine as a Branch of Antiscience

Pseudoscience attempts to masquerade as legitimate science, yet it falls short of meeting scientific standards. In contrast, antiscience positions itself as superior to and more authoritative than science. Despite their differences, the boundary between pseudoscience and antiscience often blurs, making it challenging to distinguish between the two. However, in the case of Islamic medicine, this distinction is clear: It represents antiscience outright.

Islamic medicine asserts that understanding human health and illness, along with preventive and therapeutic measures and treatments, must be derived from the religious scriptures. The religious scripture in Shi’a Islam encompasses the Quran and Sunna. Sunna is what the prophet and twelve innocent Imams, his rightful successors, have said (hadith), did, or agreed upon. Through a process called Ijtihad, Shi’a scholars derive decrees from those sources. 

Being well-trained in Ijtihad, Ayatollah Tabrizian, and his followers pursue an endeavor that has long intrigued clerics: deriving medical practices from the Islamic scripture to establish an Islamic medicine.

The Boundaries of Shari’a: Islamic Government and Islamic Medicine

It is important to clarify a few points:

First, this paper focuses on Iran’s experience, where approximately ninety percent of Iranians are officially classified as Shi’a. This designation is recorded on their birth certificates and cannot be changed later in life. While current Iranian law permits gender changes in rare cases, changing one’s religion is strictly forbidden and punishable by death. As a result, the true percentage of Iranians who genuinely adhere to Shi’a Islam is unknown. Recent polls and estimates indicate a growing trend, particularly among younger generations, towards identifying as non-religious or as followers of other religions such as Christianity and Zoroastrianism.

Second, Iran is governed as an Islamic Republic, meaning that, according to its constitution, all laws, rules, and regulations must be based on Islam or at least not contradict it. In this context, “Islam” specifically refers to Shi’a Islam. The officially recognized version of Shi’a Islam is the one that is taught in formal religious seminaries. A key concept in Iran’s Islamic Republic, known as “velayat-e faqih”, is the rule of the Supreme Leader, a senior figure (ayatollah) educated in these seminaries. Therefore, unless stated otherwise, this paper uses the term “Islam” to refer to the formal version of Shi’a Islam as practiced and interpreted in Iran.

Third, within Shi’a scholarship (comprising fuqaha or ayatollahs), there have long been debates about whether scripture or reason should be the primary source of law and ethics. “Scripture” refers to the Qur’an, considered the highest source of jurisprudence, and the Sunnah. As mentioned above, in Shi’a Islam, the Sunnah includes the sayings, actions, and approvals of the Prophet and his successors, the twelve Imams, which are recorded in various “hadith” books. Despite these debates, most Shi’a scholars aligned with the formal and ruling version of Islam in Iran maintain that when scripture provides a clear assertion or guidance, it takes precedence over reason.

Fourth, Shi’a scholars have long debated what aspects of life are covered by shari’a (fiqh or the jurisprudence and ethics derived from the Scripture) and what are not. This question has produced different answers over time. In the formal version of Islam that includes the theory of “velayat-e faqih,” it is accepted that there are such things as Islamic politics and Islamic economy—areas guided by the scripture and led by ayatollahs. However, there has been no consensus on whether there is such a thing as “Islamic medicine.”

The Role of Islamic Medicine

The current leader and the top brass of the Islamic Republic do not rely on Islamic medicine for their own healthcare. Instead, they access high-quality scientific medical treatments that are unaffordable to most Iranians. Instances like the one mentioned at the beginning of this paper are rare. While the Iranian Ministry of Health and Medical Education does support Traditional Iranian Medicine, it disapproves of Islamic medicine and frequently clashes with its practitioners. Furthermore, many high-ranking Shi’a scholars, including some who support the Islamic government, argue that Islamic medicine does not exist. They claim that the medical-related hadiths are either too few in number or insufficiently authenticated as being attributed to the Prophet or Imams to establish a distinct branch of medicine.

However, many influential Shi’a scholars, including ayatollahs, are avid supporters and providers of Islamic medicine. They contend that if politics, economics, and ethics must be derived from the Scripture, then medicine should be as well. Despite debates over the authenticity of some health-related instructions attributed to the Prophet or Imams, the sheer volume of these instructions makes it challenging for many Shi’a scholars to dismiss the existence of Islamic medicine entirely.

Practitioners of Islamic medicine, often educated in Shi’a seminaries, have strong connections in influential circles, making it challenging for the Ministry of Health to oppose them effectively. As a result, despite official disapproval, these practitioners maintain a presence in the media, including on government-controlled national TV. They continue to thrive in a profitable market by appealing to people whose religious beliefs lead them to become customers of Islamic medicine.

The COVID-19 Pandemic and The Purveyors of Islamic Medicine

The COVID-19 pandemic quickly became a fertile ground for spreading health-related disinformation as it gained global attention in early 2020. With a recovery rate of approximately 98%, proponents of unverified treatments often attributed natural recoveries to their own so-called success stories. Additionally, widespread public fear drove many anxious individuals toward self-assured promoters of “miracle cures.” Islamic medicine was quick to seek a portion of this lucrative market.

Ayatollah Tabrizian emerged as a notable purveyor of such miracle cures for COVID-19. A vocal anti-vaccine advocate, he frequently disseminated conspiracy theories through his lectures, which were shared on his popular online and social media accounts. He recommended applying violet oil to the anus as both a preventive and therapeutic measure against COVID-19, a suggestion that became a joke among Iranians. Additionally, he promoted a remedy attributed to Imam Kazim (765 – 799 CE), one of the 12 innocent Imams referred to above in Shi’a Islam, claiming it could cure all respiratory diseases, including COVID-19.

In March 2020, a video went viral showing one of Tabrizian’s students, Morteza Kohansal, inside a COVID-19 hospital ward. Without wearing a mask, Kohansal applied “Prophet’s perfume” to the noses of hospitalized patients. This dangerous behavior was extensively condemned by healthcare professionals at the time.

The Practice of Islamic Medicine

Islamic medicine is now practiced in numerous unlicensed clinics, and its products are being sold extensively by the representatives of Ayatollah Tabrizian and other purveyors all over Iran and even in other countries with Shi’a populations, such as Iraq. They are popular in social media; for example, the current number of followers of Ayatollah Tbrizian’s Telegram channel is almost 140 thousand, and it exceeded 200 thousand in the past; even though Telegram is banned in Iran and people need to use internet censorship circumvention (ICC) tools to access it. Here is a glimpse of some of the content, in addition to the treatments for COVID-19 mentioned above:

  • Their social media and other online pages are full of anti-science and anti-Western claims, such as conspiracy theories about the plans of the infidels and the imperialists to harm Muslims by depriving them of their natural remedies and religious lifestyle and, instead, selling them the products of pharmaceutical companies and genetically modified food.
  • Their understanding of human anatomy, physiology, and pathophysiology, and their terminology in these fields, are similar to that of Traditional Iranian Medicine, which is based on the theory of humors and temperaments.  The reason is apparent. The scripture they rely on was developed at a time (7th to 11th centuries BC) when those theories were dominant in the Middle East. However, they distance themselves from the philosophical bases of those theories and attribute all the processes and changes in the human body to the will and command of God.
  • For example, on the official website of Ayatollah Tabrizian, there’s a section that includes his lectures on “Islamic anatomy”. Those lectures are a funny mixture of modern, humoral, and scripture-based anatomy stitched together with magical thinking. According to them, for instance, semen is derived from vessels and hair; if during conception, the parents are under stress, their future child will resemble their (the child’s) uncles; also, the future children inherit their blood from the mother and their bones from the father (Lecture 30); the chest is made of phlegm; also phlegm comes from other organs, such as the brain, to the chest, that is why there is an overflow of sputum in the chest that makes its way to the outside of the body with coughing. The chest has a cold temperament and cools the heart to prevent it from becoming too hot and damage the body (Lecture18);  the basic material of hair and nails is “diseases,” and growing hair and nails is the body’s way to excrete diseases (Lecture #1); the reason behind some embryonic anomalies is their refusal to accept God’s creed at the time of conception; and Satan has the ability to flow within human vessels like blood and cause diseases (Lecture # 27).
  • Their preventive and therapeutic instructions and remedies are also derived from the scripture. For example, on their website, they sell potions and amulets to treat epilepsy (which they claim is caused by jinn), blood cancer, thalassemia, hemophilia, diabetes, and innumerable other conditions. These purported medications are made from a combination of various herbs. The only evidence supporting their safety and effectiveness comes from their descriptions in religious scripture and the interpretations of experts in Islamic jurisprudence and medicine. In addition, interventions such as wet cupping and bloodletting are performed according to the instructions found in the scripture.
  • In addition to the seminary-educated purveyors, many other practitioners of Islamic medicine, including many charlatans, try to gain a share of this lucrative market. Their practices include many bizarre claims, such as prescribing camel’s brain for treating platelet deficiency and camel urine for treating respiratory diseases. However, because they lack the knowledge and training to derive instructions from the scripture, it is hard to include them in the circle of valid practitioners of Islamic medicine.

An Aggressive but Declining Form of Religiosity

In his book Religion’s Sudden Decline, Ronald Inglehart describes how between 2008 and 2020, most developed countries have become less religious. In other words, organized religions have lost their popularity, and fewer percentages of people still consider themselves religious in that sense. This book also explains how, by becoming less popular, some religions become more aggressive and extremist in their social—including biopolitical—viewpoints and approaches.

Although no formal statistics exist, it is a consensual observation that in the past decades, the traditional version of Shi’a Islam has lost its popularity in Iran. The percentage of people who still follow the instructions of ayatollahs has shrunk significantly. At the same time, extremist ideas and aggressive approaches have become more prevalent among the powerful fraction of Shi’a scholars and believers who are facing social shrinkage and loss of popularity. For example, by having control of the parliament, they have passed extremist laws on family planning, abortion, and, most recently, women’s obligatory hijab, hoping to force people, especially women, to follow their medieval ideas. The recent outburst of Islamic medicine can be seen as a part of such a phenomenon.

Conclusions

Islamic medicine, as is currently promoted and practiced by some Shi’a scholars in Iran, is a branch of medical antiscience. The proponents of Islamic medicine in Iran try to integrate it into the political agenda of the Islamic government, so it becomes a part of the regime’s biopolitical agenda, along with its reproductive and forced veiling (hijab) policies. Most Shi’a scholars, either inside or outside of the government, oppose the notion of deriving an independent school of medicine from the scripture (although they agree with following the health-related instructions of the scripture in various degrees). Even most of the leading figures of the Islamic Republic don’t trust the purveyors of Islamic medicine with their health. However, the purveyors of Islamic medicine and their supporters are still powerful enough to safeguard a vast and lucrative market for practicing their medicine and marketing their products.

There are no formal statistics on the damage incurred by such practices. However, many cases, including the ones that occurred during the COVID-19 pandemic, have made their way into the media and show just the tip of the iceberg of the damage created by the purveyors of Islamic medicine in Iran. Informing people about the risks of such practices will always be part of the agenda of the proponents of science-based medicine in Iran. The same problem, with variations in their features, should be addressed in other Muslim-majority countries and Muslim communities all over the world.

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  • Kiarash Aramesh M.D., Ph.D. is an Associate Professor in the Department of Biology, Earth, and Environmental Sciences at the College of Science, Technology, and Business, at the University of Western Pennsylvania (PennWest) in Edinboro, PA, where he's also the Director of The James F. Drane Bioethics Institute. He received his Doctor of Medicine (M.D.) from Tehran University of Medical Sciences, Iran, a specialty in Community Medicine from Shiraz University of Medical Sciences, and his Ph.D. in Healthcare Ethics from the Center for Healthcare Ethics from Duquesne University in Pittsburgh, Pennsylvania. Previously, he was an Associate Professor and Vice-President for Research at the Medical Ethics and History of Medicine Research Center at Tehran University of Medical Sciences, Tehran, Iran.

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Posted by Kiarash Aramesh

Kiarash Aramesh M.D., Ph.D. is an Associate Professor in the Department of Biology, Earth, and Environmental Sciences at the College of Science, Technology, and Business, at the University of Western Pennsylvania (PennWest) in Edinboro, PA, where he's also the Director of The James F. Drane Bioethics Institute. He received his Doctor of Medicine (M.D.) from Tehran University of Medical Sciences, Iran, a specialty in Community Medicine from Shiraz University of Medical Sciences, and his Ph.D. in Healthcare Ethics from the Center for Healthcare Ethics from Duquesne University in Pittsburgh, Pennsylvania. Previously, he was an Associate Professor and Vice-President for Research at the Medical Ethics and History of Medicine Research Center at Tehran University of Medical Sciences, Tehran, Iran.