PRE-20TH CENTURY HISTORY: Public Health in Qâjâr Iran
Ebrahimnejad, Hormoz, The Middle East Journal
Public Health in Qâjâr Iran, by Willem Floor. Washington, DC: Mage, 2004. 270 pages. $50 paper.
The history of medicine in Iran has usually focused on the medieval period and its renowned physicians such as Râzi and Avicenna. Historiographical literature for modern Iran does not go beyond some articles or chapters of books, although there are far more available sources for the modern period compared with previous centuries. Willem Floor's Public Health in Qâjâr Iran is the first attempt to fill this gap by providing a general history of medicine in Qâjâr Iran (1797-1925), and despite its somehow restrictive title, addresses various issues such as diseases, therapeutics, folk as well as learned medicine, medical institutions, theories and practices, the modernization process and so forth.
Floor's interest in the history of medicine and public health stems from his research on the social history of Iran, about which he has written extensively. The book is mainly based on contemporary published materials, such as Western travel accounts, Persian diaries and state journals. The extensive linguistic ability of the author has allowed him to roam widely and to provide the reader with data from sources in not less than seven different languages. The information in these sources on everyday life such as clothing, techniques of washing, housing, animal husbandry, the treatment of the mentally ill and their place in the society, etc., are extremely rare in the medical manuscripts, which are mostly concerned with theoretical issues. Bloodletting, for instance, is systematically advised in medical manuscripts but they do not provide a real picture of this practice in the society.
Public Health in Qâjâr Iran is organized in six chapters. After a short introduction, as the first chapter, the second chapter discusses the "main diseases" that prevailed in 19th-century Iran such as various epidemic, endemic or generative diseases, including "women diseases," and psychic disorders. However, the sources do not talk about diseases systematically. Nor do they talk about diseases from a medical viewpoint, but rather from a lay perspective. As a result, the information they provide is not entirely accurate; moreover, the disease list they furnish is rather arbitrary. The chapter reflects this shortcoming to the extent that some diseases are discussed in fewer than two lines while the others occupy up to five pages. Diarrhea, for example, is mentioned under the section of "women diseases" (p. 52), rather than being discussed under "intestinal diseases" (p. 31).
A century of modern life with at least basic hygienic facilities separates us from the urban or rural communities of 19th-century Iran to the extent that we have hardly any clear idea about the environmental health problems of that time. The third chapter on "public hygiene" provides a striking picture of the unhygienic conditions of the population. This chapter helps us to appreciate better the extent to which the effects of the epidemics were amplified by the absence of "public health" measures and to understand better the phenomenon of under-population in Qâjâr Iran.
Chapters 4 and 5 constitute the core of the volume in that they examine the two pillars of the medical system: medical knowledge and medical institutions. The medical knowledge is divided into Galenic medicine, folk medicine, and Prophetic medicine. However, the terminology used to elaborate on this classification (pp. 68 ff) is rather puzzling and does not stand historiographical or theoretical analysis. Medicine of the Prophet, for instance, considered by Floor as a distinct medical system, was rather folk medicine, sanctioned by being attributed to the Prophet. Likewise, the term tebb-e sonnati, literally "traditional medicine," is a modern term to designate learned medical literature based on Avicennian and Galenic theories and does not signify folk medicine, as Floor believes. It was not before the second part of the 19th Century that the term tebb-e qadim (old medicine) emerged to distinguish Galenico-Avicennian medicine from tebb-e jadid (modern medicine), which had been introduced from Europe. …