وَإِن يَمْسَسْكَ اللَّهُ بِضُرٍّ فَلاَ كَاشِفَ لَهُ إِلاَّ هُوَ وَإِن يُرِدْكَ بِخَيْرٍ فَلاَ رَآدَّ لِفَضْلِهِ يُصِيبُ بِهِ مَن يَشَاءُ مِنْ عِبَادِهِ وَهُوَ الْغَفُورُ الرَّحِيمُ

Prophet’s Guidance in treating tumors and abscesses with surgery

فَصْلٌ فِي هَدْيِهِ صَلَّى اللَّهُ عَلَيْهِ وَسَلَّمَ في علاج الأورام، والخراجات الَّتِي تَبْرَأُ بِالْبَطِّ وَالْبَزْلِ

Guidance of Prophet Muhammad صلى الله عليه وسلم for Treating Swellings and Abscesses that Heal Through Incision and Drainage

يُذْكَرُ عَنْ علي أَنَّهُ قَالَ: دَخَلْتُ مَعَ رَسُولِ اللَّهِ صَلَّى اللَّهُ عَلَيْهِ وَسَلَّمَ عَلَى رَجُلٍ يَعُودُهُ بِظَهْرِهِ وَرَمٌ، فَقَالُوا: يَا رَسُولَ اللَّهِ! بِهَذِهِ مِدَّةٌ. قَالَ: «بُطُّوا عَنْهُ» ، قَالَ علي: فَمَا بَرِحْتُ حَتَّى بُطَّتْ، وَالنَّبِيُّ صَلَّى اللَّهُ عَلَيْهِ وَسَلَّمَ شَاهِدٌ  (أخرجه أبو يعلى: وفي سنده أبو الربيع السمان)

Ibn al-Qayyam wrote : It is narrated from Ali (may Allah be pleased with him) that he said, “I once went with the Messenger of Allah, Prophet Muhammad صلى الله عليه وسلم to visit a man who had a swelling on his back. They said, ‘O Messenger of Allah, this swelling has been here for a long time.’ Prophet Muhammad صلى الله عليه وسلم instructed, ‘Incise it.’ Ali said, ‘I stayed there until it was incised, with the Prophet ﷺ present.”

وَيُذْكَرُ عَنْ أَبِي هُرَيْرَةَ، أَنَّ النَّبِيَّ صَلَّى اللَّهُ عَلَيْهِ وَسَلَّمَ أَمَرَ طَبِيبًا أَنْ يَبُطَّ بَطْنَ رَجُلٍ أَجْوَى الْبَطْنِ، فَقِيلَ: يَا رَسُولَ اللَّهِ: هَلْ يَنْفَعُ الطِّبُّ؟ قَالَ: «الَّذِي أَنْزَلَ الدَّاءَ، أَنْزَلَ الشِّفَاءَ، فِيمَا شَاءَ (زاد المعاد)

It is also narrated from Abu Hurairah (may Allah be pleased with him) that Prophet Muhammad صلى الله عليه وسلم ordered a physician to incise the abdomen of a man who had abdominal dropsy (severe abdominal swelling). People asked, “O Messenger of Allah, does medicine have any benefit?” Prophet Muhammad صلى الله عليه وسلم replied, “The One who sent down the illness has also sent down the cure for it, in whatever form He wills.”

Swelling: This refers to an unnatural accumulation of matter in the size of an organ due to an influx of excess, unnatural substance. It can occur across different types of diseases and is composed of various elements such as the four humors, water, and air. When swelling intensifies, it is called an abscess. Every hot (inflamed) swelling generally leads to one of three outcomes: dissolution (breaking down of the matter), the formation of pus, or a transition to hardness. If the body’s strength is sufficient, it overcomes the swelling material and dissolves it, which is the best outcome for the swelling. If the strength is moderate, it matures the matter into white pus and opens a space for it to drain. If the strength is weak, the matter turns into immature pus, and the body cannot open a pathway to expel it, risking harm to the organ if it remains there. In such cases, medical intervention, like incision or other means, may be necessary to release the harmful, deteriorating matter from the organ.

There are two benefits to incision:

• Removal of the harmful, deteriorating matter
• Prevention of further accumulation of similar matter that could strengthen the swelling

As for the Prophet’s statement in the second Hadith, “He ordered a physician to incise the abdomen of a man with abdominal dropsy ( أَجْوَى الْبَطْنِ ~Ajwa’ al-Batn),” the term Ajwa’ can refer to various conditions, one of which involves putrid water accumulating in the abdomen, leading to dropsy (abdominal swelling).

There has been a difference of opinion among physicians regarding incision to drain this fluid. Some practitioners discourage it due to its risks and the slim chances of full recovery. Others, however, consider it necessary, believing that no other treatment is effective. This procedure is typically considered in the case of "Ziqqi" dropsy, one of the three types of dropsy:

(1). Tabli (drum-like~ طَبْلِيٌّ): In this type, the abdomen swells with a gaseous substance, producing a drum-like sound when tapped.

(2). Lahmi (fleshy~ لَحْمِيٌّ): In this type, the body’s entire flesh swells due to a phlegmatic substance spreading with the blood throughout the body, which is more challenging to treat than the first type.

(3). Ziqqi (water-sack~ زِقِّيٌّ): Here, a harmful fluid collects in the lower abdomen, producing a sloshing sound when the body moves, similar to water in a sack. Many physicians regard this as the worst type, though some consider the “fleshy” type more severe due to the generalized swelling it causes.

One approach to treating Ziqqi dropsy involves drainage by incision, which is similar to phlebotomy used to release harmful blood, though it carries significant risks, as previously mentioned. If this Hadith is proven authentic, it serves as evidence for the permissibility of incision in such cases. And Allah knows the best.