Cautery (al-kayy)

Cautery is treatment by fire, and the reports on it include some in which the Prophet has it done and some in which he dislikes it. In al-Bukhari: 'healing is in three things: a drink of honey, the cut of a cupper's blade and a burn of fire, and I forbid my community to cauterise' ¹, and 'I do not like to be cauterised' ²; in Muslim the Prophet seared the wound of Sa'd ibn Mu'adh ³; in Abu Dawud 'Imran ibn Husayn says 'the Prophet forbade cautery' ⁴. Ibn Qayyim al-Jawziyya reconciles them by saying they are of four kinds, his act, his not liking it, his praise of those who leave it and his prohibition, and finds no contradiction among them ⁵.

Ibn al-Qayyim relates that the Prophet sent a physician to Ubayy ibn Ka'b, who cut a vein and cauterised the place ⁶ Muslim 5745; that Sa'd ibn Mu'adh was struck in the akhal vein and the Prophet seared the wound, then it swelled and he seared it a second time, 'searing' being cautery ^{6 3} Muslim 5748. He reports that a man of the Ansar struck in the akhal with an arrowhead was cauterised on the Prophet's order, and that when a man was brought for whom cautery had been described the Prophet said 'cauterise him and heat stones for him' ⁵. He cites Anas saying 'I was cauterised for pleurisy while the Messenger of God was alive' ⁷ al-Bukhari 5719, and, in al-Tirmidhi, the Prophet's cauterising of As'ad ibn Zurara for al-shawka ⁵. The Muwatta carries a report that As'ad ibn Zurara was cauterised in the Prophet's time for a throat ailment and died ⁸ Muwatta 2719, and that Abd Allah ibn Umar was cauterised for facial paralysis and was treated with a charm for a scorpion sting ⁸ Muwatta 2720.

Al-Bukhari reports from Ibn Abbas: 'healing is in three things: a drink of honey, the cut of a cupper's blade and a burn of fire, and I forbid my community to cauterise' ¹ al-Bukhari 5680, and from Jabir the Prophet's words on remedies, 'a burn of fire that suits the disease, and I do not like to be cauterised' ² al-Bukhari 5683. 'Imran ibn Husayn says: 'the Prophet forbade cautery; we cauterised and neither prospered nor succeeded' ⁴ Abu Dawud 3865, and in al-Tirmidhi 'we were forbidden cautery' ⁵ al-Tirmidhi 2049. In the report on the seventy thousand who enter Paradise without reckoning they are those who 'do not seek charms, do not cauterise, do not take omens, and put their trust in their Lord' ⁹ al-Bukhari 6541 al-Bukhari 5752.

Ibn al-Qayyim sets out the scholars' ways of reconciling these reports. Abu Abd Allah al-Mazari holds that cautery was named among the remedies because it is used when the body overcomes the force of drugs and where a drink does not help, so it is the last of medicine, and that 'I forbid my community to cauterise' and 'I do not like to be cauterised' point to delaying it until necessity demands and not hurrying to it, since it brings on severe pain to remove a pain that may be milder ¹⁰. Al-Khattabi says the Prophet cauterised Sa'd only to stop the blood from his wound, fearing he would bleed to death, and that cautery is used in this way as when the amputated limb is seared; the prohibition is on cauterising in order to seek healing, since people believed that without it they would die, so he forbade them for the sake of that intention; it is also said that the prohibition was addressed to 'Imran ibn Husayn in particular because he had a fistula in a dangerous place ⁵. Ibn Qutayba says cautery is of two kinds: cauterising a healthy person to prevent illness, of which it was said that whoever cauterises has not trusted, since he wants to ward off the decree; and cauterising a festering wound or an amputated limb, in which there is healing; cautery for treatment that may or may not work is nearer to disliked ⁵. Ibn al-Qayyim himself sorts the reports into four kinds, his act, his not liking it, his praise of those who leave it and his prohibition, and says his act shows cautery is permitted, his not liking it does not show it is forbidden, his praise of those who leave it shows leaving it is better, and his prohibition is by way of choice and dislike or concerns the kind that is not needed and is done for fear of illness ⁵.

Ibn al-Qayyim relays from some physicians that material diseases are either acute, reaching one of the two outcomes quickly, so cautery is not needed, or chronic, for which after evacuation the best treatment is cautery in the organs where it is permissible, because a chronic disease arises only from a cold, thick matter lodged in the organ that has spoiled its temperament ¹⁰. Al-Mazari ties the mention of honey, cupping and cautery to the kinds of plethoric diseases, sanguine, bilious, phlegmatic and melancholic ¹⁰ cupping honey. For the wider topic see prophetic medicine.

This page reports what the sources say of cautery and of reconciling its reports, with no preference among them; it gives no medical advice and no legal ruling.