Dissection

Assalaamu'alaikum,

Dissecting Human Dead Bodies for Medical Purposes

In the first place, we would like to note that Islam cares much for a person whether dead or alive. Jabir Ibn `Abdullah (may Allah be pleased with him) said: “One day we accompanied the Prophet (peace and blessings be upon him) in a funeral of a person. When we reached the graves, we sat down. The gravedigger brought out a bone- of a leg or another organ- and began to break it. The Prophet (peace and blessings be upon him) said: ‘Do not break it, for breaking this bone, even after the death of its owner, is like breaking it while he/she is alive.’” (Reported by Malik, Ibn Majah and Abu Dawud)

Handling the issue of dissecting human dead body for medical purposes or the like, Sheikh `Attiya Saqr, former Head of Al-Azhar Fatwa Committee, issues the following fatwa:
In fact, there is no religious text tackling directly the issue of using the organs of the dead for medical or scientific research. The issue is controversial among Muslim scholars; each making his own Ijtihad (Personal Reasoning).

In the fatwa issued by the Egyptian House of Fatwa on 31st Oct. 1937 on the issue of dissecting the belly of a dead person who swallowed an amount of money, it is stated:
The Hanafi scholars permit dissecting the belly of such a person if the money belongs to another person and the deceased left no money that can be given to the owner. The simple reason for this is that the right of a human being takes priority over the right of Allah and the right of the wrongdoer. It goes without saying that it was a wrong thing done by the deceased by unjustifiably taking a person’s money.

The view of the Shafi`i scholars is that they permit dissecting the belly of a dead person for the purpose of taking out money without giving further details on the issue. The same view adopted by Maliki jurist, Sahnun, while Ahmad holds the opposite view.

As for opening the belly of a dead mother for the very purpose of taking out the baby, the Hanafi scholars permit it if the baby is known to be alive, for this will help in saving the life of a human being. The same view is upheld by Shafi`i scholars while the Malikis and the Hanbalis disallow it.

The correct opinion is that the rules and the objectives of Shari`ah indicate that if there is a benefit behind opening the belly of a dead person, leading to establishing the cause of death or restoring back a right, then dissection is permissible in this case.

The Fatwa of late Sheikh Jadul-Haq `Ali Haq, former Grand Imam of Al-Azhar (may Allah bless his soul) also reads:
According to both Imam Abu Hanifah and Ash-Shafi`i, it is permissible to open the belly of a dead person, if there is a valid reason for doing so, such as taking out a living baby or valuable or precious thing (money or jewelry or the like) that the person has swallowed. The view of Malik and Ahmad is that it is allowable to do so in case of money and not in case of a baby. I myself support this view. To me, there is nothing wrong in opening the belly of a dead person so as to take out something valuable such as a living baby or money of considerable value.

As for using human organs after death, late Sheikh Jadul-Haq adds:

It is permissible, if the deceased is of unknown personality or family, to take his/her bodily organs and use it in treating another person or for medical research. All these are in fact very important and of general benefit for all Muslims.

Now, to the question of using the bodily organs of a dead person for research purposes. The Fatwa of Sheikh `Ikrimah Sabri, the Mufti of Al-Quds & the Khatib of Al-Aqsa Mosque, states:
Islam shows unprecedented care for the needs of man and the necessities of life. It makes it permissible to reveal the private parts of a male or a female in case of necessity. All this stems from the juristic rules: “Necessity dictates exceptions.” This rule is also governed by another rule that reads: “Necessities are duly estimated."

It is thus permissible to dissect the dead body of a person with the very aim of discovering diseases or finding out a treatment or knowing the functions of bodily organs and the component of human body. It is also permissible to resort to carry out this process for the purpose of knowing the reason that caused the death of a person, and this will be useful for homicidal investigation. Using the bodily parts of a dead person is also permissible for the students of medicine who do so as a way of training. However, this is to be carried out in a place specialized for that purpose and not open for everybody.
By and large, dissecting human dead bodies for medical research is permissible so long as the Islamic morals of preserving the body and confining the process to such medical purposes are maintained.

Elaborating on the issue of conducting postmortem, we would like to cite for you the following:
A postmortem is permissible if it is conducted for the right purpose. We can say that determining the cause of death, either when a crime is suspected or to enable medical students and their teachers to learn about the effects of certain diseases, is a legitimate purpose to carry out a postmortem. Many people are under the impression that postmortems are forbidden in Islam. It is certainly forbidden to show disrespect to or assault the dead body of any person. Islam forbids the disfigurement of enemy soldiers in battle. It would certainly not allow the cutting up of dead bodies for idle play. A legitimate purpose, however, is different. If a medical purpose is not legitimate, what is?

Source: www.islamicity. com

Dr. Muzzamil Siddiq, former President of Islamic Society of North America (ISNA), adds:
Dissection of the human bodies for the purpose of medical education is allowed in Islam. There is a basic rule in the Shari`ah that says: “What is necessary for the fulfillment of an obligation, becomes an obligation itself.” It is obligatory to treat people and perform surgeries on them when they need. To perform this obligation it is necessary to study human anatomy and for this purpose dissection has to be done as and when necessary.

It is, however, important that the bodies should be taken with the consent of the deceased or his/her relatives. If the deceased had no relative and his/her body was unclaimed, then such bodies can be used for the dissection purpose only with the permission of a local other legal authorities.

The Prophet (peace and blessings be upon him) said: “The ruler (or the legal authority) is the guardian of him who has no guardian.” If a Muslim’s body is used for the dissection, then it should be washed. Funeral prayer should be performed before the dissection. After the dissection all the parts of the body should be collected in a bag and then they should be properly buried. I am told that some Muslim medical schools did follow this procedure.

However, stealing the bodies from the graveyards is prohibited. This is exactly a grave sin. A Muslim should neither steal a dead person’s body, nor should Muslim medical students buy or use such bodies. Those who have done that out of ignorance should make repentance to Allah and ask His forgiveness.

Excerpted, with slight modifications, from: www.pakistanilink. com

In conclusion, it is to be noted that scholars have a lot to say on the issue at hand, but as we have noticed the preponderant view is that dissecting human dead bodies is permissible on the condition that it is done while adhering to the Islamic regulations stated above which aim at maintaining the highest degree of security and safety of the body.

Kejadian Manusia

Friday, May 15, 2009

HYPOGLOSSAL NERVE (CN-12)

Assalaamu'alaikum, Ketemu lagi dengan izin Allah.

Hari ni saya nak kongsi ilmu tentang saraf HYPOGLOSSAL.

1. Hypoglossal nerve adalah saraf kranial yang ke-12.
2. Ia adalah saraf menuju ke lidah.
3. Serat-serat saraf hypoglossal adalah serat MOTOR (purely motor).
4. Ia mensarafi otot-otot lidah.
5. Serat-serat saraf hypoglossal berasal daripada nucleusnya iaitu di batang otak (medulla oblongata).

Sila lihat PLATE-122 ATLAS OF HUMAN ANATOMY FRANK H.NETTER

6. Perhatikan gambar pada atlas, saraf hypoglossal ini muncul daripada nucleusnya dengan beberapa akar (sebenarnya 10-15 rootlets).

Sila lihat pula PLATE 108 ATLAS.

7. Akar-akar serat saraf hypoglossal melekat (attached)pada batang otak medulla melalui celah yang menegak (vertical groove) yang memisahkan antara pyramid dan olive.

8. Lihat kembali PLATE-122, akhirnya akar-akar serat saraf hypoglossal bersatu dan keluar meninggalkan kaviti tengkorak (skull) melalui bukaan yang diberi nama hypoglossal canal. Lihat PLATE-7 untuk melihat hypoglossal canal dengan lebih jelas.

9. Seterusnya, setelah keluar daripada hypoglossal canal yang terletak pada bahagian bawah tengkorak, saraf hypoglossal kelihatan berada pada posisi yg lebih dalam (deep) dan agak medial daripada internal jugular vein (IJV) dan internal carotid artery (ICA).

10. Ia kemudian turun ke bawah dan keluar (lateral) supaya ia berada sekarang betul-betul diantara IJV dan ICA dan terus turun diantara IJV dan ICA sampai pada level angle of mandible. Lihat juga hypoglossal nerve dalam gambar PLATE 123. Di sini, saraf hypoglossal akan berlalu ke depan dan (lihat kembali PLATE-122) memintas internal dan external carotid arteries (ICA & ECA) seterusnya masuk ke kawasan submandibular.

11. Dalam kawasan submandibular ini, saraf hypoglossal pada mulanya superficial to hyoglossal muscle dan apabila terus ke depan, ia menjadi superficial pula to genioglossus muscle.

12. Saraf hypoglossal berhenti (tamat) dengan membahagi kepada cabang-cabangnya (terminal branches).

13. Cabang-cabang inilah nanti akan mensarafi kesemua otot lidah intrinsic dan juga extrinsic muscles KECUALI SATU --> PALATOGLOSSUS muscle, kerana otot lidah yang satu ini disarafi oleh saraf lain iaitu saraf ACCESSORY (CN11- cranial part).

Mari kita lihat anatomi lidah terlebih dahulu. Lihat PLATE-122 Lidah.

1. Lidah terletak dalam kaviti mulut.
2. Bahagian depan lidah yang boleh dijelir disebut apex.
3. Lidah mempunyai permukaan atas dan permukaan bawah yang bebas.
4. Tetapi sebahagian besar daripada lidah terlekat di lantai kaviti mulut.
5. Bahagian yg melekat itu disebut ROOT of the tongue.
6. Permukaan atas lidah yang bebas itu disebut DORSUM.
7. Tepian kiri dan kanan lidah disebut LATERAL EDGES juga bebas daripada perlekatan.
8. Keseluruhan permukaan bebas lidah diliputi membran mukosa.
9. Kandungan lidah adalah semata-mata otot.
10. Sebahagian otot disebut INTRINSIC kerana ia berasal daripada dalam lidah dan berakhir di dalam lidah. Selebihnya otot-otot EXTRINSIC iaitu yang berasal daripada luar lidah ke lidah.
11. Otot-otot extrinsic masuk ke lidah melalui root of the tongue.

Otot-otot extrinsic lidah. Lihat PLATE-122:

a) Styloglossus
b) Palatoglossus
c) Genioglossus
d) Hyoglossus

12. Melaui otot-otot extrinsic inilah lidah ditambat ke hyoid bone di belakang (through the hyoglossus muscle) dan ditambat ke tulang mandible di depan (through the genioglossus mescle).

CABANGAN (Branches) SARAF HYPOGLOSSAL.

Cabangan-cabangan saraf ini bolehlah dibahagikan kepada 2:

1. Cabang-cabang jelas (proper)
2. Cabang-cabang yang terwakil daripada serat-serat saraf cervical 1 dan kemudian bergabung sebagai hypoglossal nerve. Lihat PLATE- 27 sekarang (gambar bawah).

i. Kita telah lihat bahawa Hypoglossal nervelah yang mensarafi otot-otot intrinsic dan otot-otot extrinsic lidah yang 3 (stylo-, hyo- dan genio-glossus muscles).

ii. Lihat PLATE 122 kejap. Lihat, semasa saraf hypoglossal melalui hypoglossal canal (sebelum keluar) ia telah memberi satu cabangan kecil iaitu MENINGEAL branch dan patah ballik ke dalam kaviti tengkorak untuk mensarafi selaput meninges. nampak tak? kalau tak nampak suruh kengkawan tunjuk.

iii. Pernah dengar ANSA CERVICALIS? Lihat PLATE-27 cari ansa cervicalis dulu. Hypoglossal nerve melaui serat saraf cervical 1 memberi cabangan menurun (descending) yg membentuk the SUPERIOR ROOT OF ANSA CERVICALIS.

iv. Melaui serat-serat sarafnya daripada cervical nerve 1, hypoglossal nerve juga mensarafi 2 otot lagi; Lihat PLATE-27 (gambar leher atas) iaitu:

1. thyrohyoid muscle
2. geniohyoid muscle

Amacam? Dah boleh faham dah? Alhamdu lillah..

InsyaAllah, Akan datang kita lihat applikasi klinikalnya pula. Fahamilah yg normal dulu ya.

WASSALAAM.
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