Soul and Body

The reciprocity between soul and body represents one of the core principles of Arabic medicine. Arab physicians took a massive interest in explaining the mutual influence of these two dimensions of the human being and using it to optimise treatment.

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Note of the Editor: This article, “Soul and Body” written by Pauline Koetschet, is Chapter Five, Pages 60-67, extracted from the book “1001 Cures: Contributions in Medicine & Healthcare from Muslim Civilisation” editor Peter Pormann, published by the Foundation for Science, Technology and Civilisation, UK. The content of this chapter is relevant to the current pandemic environment around the world.

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Figure 1. A 16th-century Persian miniature depicting Ibn Sina (Avicenna) at the bedside of a patient suffering from love-sickness (ʿishq). According to Arabo-Islamic physicians, the overall functioning of the body demonstrated the reciprocity between the mixture of the humours on one side and psychological events on the other.

The reciprocity between soul and body represents one of the core principles of Arabic medicine. Arab physicians took a massive interest in explaining the mutual influence of these two dimensions of the human being and using it to optimise treatment. In their attempts to explain this reciprocity, physicians engaged with several issues in natural philosophy, such as the nature of the soul and the seat of the rational part of the soul.

We should begin with a preliminary remark on the use of the terms ‘soul’ and ‘mind’. In the Arabic medieval medical texts, the word most frequently used to designate the psychological dimension of the human being is nafs, best translated as ‘soul’. The intellectual faculties which form our understanding of ‘the mind’ comprise only a part of what was conveyed by the ancient and medieval notions of ‘the soul’. However, the modern state of the mind-body problem contributes to the confusion between ‘mind’ and ‘soul’. To avoid this confusion, I will use the term ‘soul’ throughout this article, and I reserve ‘mind’ for the intellectual and the rational faculties.

In the first part of this article, I will introduce the conceptual framework of the reciprocity between soul and body, and investigate its general application. In the second part, I will focus on the specific case of mental illnesses, where this reciprocity is of crucial importance, both for the aetiology of these illnesses and for their treatment. Finally, in the third part, I will approach the ethical ramifications of the medical understanding of the soul-body reciprocity.

Medicine and Psychology

Figure 2. Inside the Arghūn hospital in Aleppo where water features were essential. The soft sound of water soothes the mind. The architectural features of this 14th-century hospital reflect a careful consideration to the needs of patients.

According to Arabo-Islamic physicians, the overall functioning of the body demonstrates the reciprocity between the mixture of the humours on one side and the psychological events on the other. This is the reason that primary qualities (in other words, the mixture of hot and cold on one side, and dry and moist on the other), have a strong influence on an individual’s moral character: if the mixture of the humours is globally hot, the person will get angry quickly; but if it is globally cold, he will be fearful and slow by nature. Conversely, the state of the soul has an impact on the bodily balance: psychological affections (al-ʾaḥdāth al-nafsānīya), such as anger, sadness, worry, fear, and pleasure, belong to the eight ‘non-natural’ factors that can be acted upon to modify the mixture of the humours. In his Introduction to the Art of Medicine, when describing these factors, al-Rāzī explains:

“Psychological affections: some of them set into motion at once the innate heat towards the surface of the body, such as anger. Anger is the name of the agitation of the soul towards a person against which [the soul] seeks revenge, and it is [equivalent to] the boiling of blood and intense agitation coming from the choleric faculty that is seated in the heart. Conversely, sadness is the name of the weakness of the soul when it becomes desperate at something. Desire sets at once into motion the heat towards the surface of the body. Worry sets it into motion sometimes towards the inner parts of the body, and sometimes towards the external parts. Pleasure sets it gradually into motion towards the surface of the body.” [Concepción Vázquez de Benito 1979, 38]

The soul-body reciprocity is the reason that the physician should always pay particular attention to his patient’s emotional and spiritual state. An aphorism, attributed to al-Rāzī, insists that ‘the physician, even though he has his doubts, must always make the patient believe that he will recover, for the state of the body is linked to the state of the mind’ (Ibn Abī Uṣaybiʿa, History of Physicians, I, 314, 28–29 (trans. Pormann/Savage-Smith 2007, 41)). Sadness and anxiety are to be avoided, while music, recreational activities such as chest games and hunting, and the pleasant company can all contribute to a better recovery. In many cases, physicians report the use of psychosomatic tricks as part of the treatment itself. For example, in his treatise On Melancholy, Ishāq ibn ʿImrān gives the example of a melancholic patient living near Kairouan, who believed that he did not have a head. His doctors made him wear a tiara made of lead. As a result, he realised that he had a head (ed. Omrani 2009, 49). In another story, which seems to represent more of a literary topos than an account of a real case, the Persian king Qābūs ibn Vušmagīr sent for Ibn Sīnā to treat one of his relations who had fallen seriously ill. Through clever questioning, Ibn Sīnā diagnosed love-sickness (ʿishq) (Browne 1921, 88–_90).