Diarrhoea

Introduction

The same way that having a healthy body relies upon eating useful and healthy foods, it also relies upon the excretion of toxic and excess materials from the body. A healthy body will excrete the excess and toxic materials from itself in a natural fashion but if the body is unable to excrete the toxic materials, it will fall ill. Finding an appropriate way to remove the excess materials from the body by turning to medicines which remove excess materials is called takhliyah (medicine-induced excretion). Diarrhoea is one of the methods of takhliyah, as is cupping, bloodletting, injections and self-induced vomiting. The medicine which causes diarrhoea is called a laxative. In common medicine, prescribing laxatives is uncommon. In cases in which they wish to empty the bowels in order to take an x-ray or to operate, they will give the person laxatives which, in reality, is only to set the foundation for diagnostic and medical examinations and not in order to remove toxic materials and cure illnesses. Some prescribe laxatives for patients suffering from constipation which is wrong as until the patient hasn’t become accustomed to the effect of the medicine, it will cause movement in the bowels but it doesn’t cure constipation and on the contrary, it will be strengthened after a while by urination. However, in Islamic and traditional medicine, laxatives are prescribed for different illnesses in order to solve different problems and this method of takhliyah has a large chapter in Islamic and traditional medicine.

Narrations regarding this method of takhliyah

The Holy Prophet said in a narration,

“All illnesses and all cures are three kinds; the illnesses are hyperaemia, mirrah (Safra (yellow bile) and sawda (black bile)) and balgham (phlegm). The cure of hyperaemia is cupping, the cure of balgham is showering and the cure of mirrah is laxatives.”

The Holy Prophet said in a narration,

“The best things from which you can seek a cure are a medical snuff, ludud (a bitter medicine which is beneficial for the stomach), cupping and taking laxatives.”

Imam Sadiq said,

“A fever leaves the body through three things; sweat, laxatives and medicine-induced vomiting.”

Imam Rida said in Risalah Dhahabiyyah,

“The season of spring is the spirit of the year and its first month is March… It is preferred to take laxatives and to perform bloodletting and cupping.”

In a general fashion, Islamic and traditional medicine is based on the foundation that eating more than the needs of the body is wrong and on the other hand, excess and toxic materials attained from digesting the food should be expelled from the body as soon as possible. It is for this reason that Imam Rida said,

“He who wishes for his bladder to not be damaged should not hold his urine in, even if he is a moving rider.”

This shows that in these conditions, he should stop his animal, urinate and not wait until he reaches home. Amir al-Muminin Ali also says in advice to his son,

“O’ son, should I inform you of four characteristics which will make you needless of medicine? Do not eat food unless you are hungry, stop eating before you are full, chew your food well and go to the toilet before sleep. Therefore, if you do this, you will be needless of medicine.”

In this narration, we also see that one of the four pieces of advice of the Imam to become needless of medicine is emptying the body of toxic materials and going to the toilet before sleep. Therefore, Islam emphasises that the toxins attained through digestion of food must be emptied from the body quickly.

Definition of diarrhoea

The passing of faeces in an unnaturally watery or unformed fashion and exits in a continuous fashion. From a scientific point of view, more than 200 grams of faeces in a day is called diarrhoea. They call diarrhoea which continues for less than two weeks hadd (sharp) diarrhoea and diarrhoea which continues for more than four weeks is called muzman (chronic) diarrhoea. The softness of faeces differs from diarrhoea. The first means the looseness and softness of the faeces which is the physiological and natural state of the bowels while diarrhoea has an unnatural, abnormal and watery state.

Difference between purgatives (mulayyin) and laxatives

1. Purgatives is that which removes what is in the stomach, bowels and that surrounding it from the body while laxatives are that which moves the illness from the stomach, bowels and that surrounding it from the whole body into the intestines and then brings it out.
2. In prescribing purgatives, there is no need for prescribing aperients, even though it is better to use aperients (mandaj), but before prescribing laxatives, you must first prescribe aperients.
3. Purgatives can be prescribed to people of any nature, temperament and age (e.g. Chinese cinnamon), even to pregnant women, newborns and the elderly. In reality, purgatives are a weak softener of the faeces but laxatives are a strong diluent of faeces. Therefore, one must prescribe laxatives with greater precaution.

Rules and points related to laxatives

That which must be observed before using laxatives

1. Before using the medicine, the person must abstain from eating things which may damage the stomach, liver or bowels. He must also abstain from fasting, hunger, hard and toiling work, sexual intercourse and anything that weakens the body.
2. If before using laxatives, the person had used a purgative for moderate temperament (i.e. they took a course of purgatives), they will then be safe from the side-effects of the laxatives.
3. Someone who wants to use the method of diarrhoea or self-induced vomit should eat a variety of food and eat several times throughout the day as the stomach then wishes to remove that which it contains, be it from the top (self-induced vomit) or from the bottom (diarrhoea).
4. It is better for people with hot temperaments to first consume barley extract or pomegranate juice and then to use the laxatives.

That which must be observed after using the medication

1. It is better to sleep after eating the laxative.
2. The person who ate the laxative must be in relatively warm weather.
3. One should bathe after eating laxatives as bathing stops diarrhoea.
4. It is better to abstain from eating and drinking after eating laxatives until the medication takes effect and it does its work.
5. It is better for the person not to sleep after the laxative takes effect.
6. If the person experiences dizziness after eating the laxative, its cure is to drink hot water as drinking hot water after eating laxatives strengthens its effect i.e. whenever the laxative is eaten, one should drink hot water after it.
7. One of the signs of the end of the diarrhoea is thirst.
8. If eating the laxative doesn’t cause diarrhoea for the patient, you can then dilute mastic into hot water along with rock candy or Chinese cinnamon and feed it to the patient in order to open up the bowels. If the way still doesn’t open, vomiting the laxative is better than feeding the patient more laxatives.

Things to do after medication

1. In order to remove the side-effects of the laxative, it is better to drink barley extract after the completion of the diarrhoea.
2. Barley wheat is one of the strongest refiners of the smell of breath which sometimes arise after taking laxatives.
3. Phlegmatic people should boil garden cress in water after the completion of diarrhoea and eat what remains with olive oil.
4. People with hot temperament (yellow bile and blood) should eat plantains (one of the medicinal and effective plants in curing diarrhoea) with cold water or violet oil with rock candy and rose water after the completion of the diarrhoea.

General issues regarding the consumption of laxatives

1. Laxatives can be eaten in the spring or the autumn.
2. The best time for laxatives to take effect is in the early morning.
3. It is better for patients with pain in the splenic vein to eat a stronger laxative.
4. Eating laxatives in the harsh cold of winter is harmful.
5. Hellebore is one of the extraordinarily strong laxatives found in nature.
6. People who have a moderate temperament should eat flax seeds after eating the laxatives.
7. Golden shower tree, violet and brown sugar are some of the harmless and light laxatives of nature.
8. One should never take two kinds of laxatives in one day or at the same time.
9. The corrector (muslih) of the laxative’s side-effects include mint, rue, celery, quince and redcurrant (a bitter forest fruit which has anti-microbe characteristics).
10. Taking laxatives is not allowed for thin people except in cases of necessity.
11. The best form of laxative is when it is in a capsule i.e. the power of the effect of the medicine won’t be affected by travel down to the stomach.
12. The best medicine for someone who has a fever after eating laxatives is barley extract.
13. People with unnatural diarrhoea due to ulcerative colitis or Crohn’s disease (chronic and bloody diarrhoea which is normally seen in people with an O blood type due to the thinness of their blood) should consume Armenian soil diluted in pomegranate juice after the completion of diarrhoea.

Issues in which use of laxatives is prohibited

1. People with dry temperament
2. Surfeit and overeating
3. Cold atmosphere
4. The weak and elderly
5. Obese and thin people
6. Obstruction of the intestines (like appendicitis)
7. Dry faeces in the intestines
8. Mute people
9. People with stomach diseases

Definition: Taking laxatives for no reason is prohibited for the elderly but in cases of pressing need of takhliyah at that age, the person in question should choose laxatives as the best method of takhliyah under the supervision of a doctor.