Medical Healers in Ottoman Egypt, 1517–1805

Abstract

Although the history of modern medical reforms in nineteenth-century Egypt has received considerable attention from historians and scholars, the history of medicine when the country was under Ottoman rule from the sixteenth to the eighteenth century, is still largely unexplored.1 In the opinion of many scholars this was a time when the medical sciences in Egypt declined, qualified learned physicians were rare and people relied mainly on ignorant barbers and charlatans, and the period was deemed unworthy of study.2 This lack of interest mainly stems from the opinion of the physicians who accompanied the French expedition of 1798–1801 and other European physicians assigned to reform medicine in early nineteenth-century Egypt. Foremost among these was the French surgeon Antoine-Barthelemy Clot-Bey, entrusted by Muhammad Ali Pasha, ruler of Egypt from 1805 to 1848, to reform the country’s medical education and practice. Many of Clot-Bey’s writings provided readers with a gloomy picture of the status of Egyptian health care. He maintained that Egyptians preferred quackery to rational medicine; there were no qualified practitioners, only barbers and midwives; therapeutics were primitive and limited; and, finally, medical techniques were barbarous and disastrous.3 Although such views had a long lasting influence on the study of the history of medicine in Ottoman Egypt, revisionist scholarship has warned against blindly accepting them. The comments of French writers on eighteenth-century Egyptian medicine, as J Worth Estes and LaVerne Kuhnke argue, reflected the perspective of Enlightenment scholars and physicians for whom European culture was superior to all others, and who regarded themselves as “torch bearers” of European civilization, art and science.4 Estes and Kuhnke’s study shows that 78 per cent of the medical drugs used in Ottoman Egypt were also used in eighteenth-century France for the same clinical purposes, because both western and Egyptian physicians still functioned within the system of humoralism.5 Other scholars have also successfully challenged some of the accepted statements about medical care in Ottoman Egypt. Michael Dols’ study of medicine in sixteenth-century Egypt asserts that physicians were aware of the medical remedies used in Renaissance Europe, especially for the treatment of diseases that originated in the West such as syphilis.6 Despite the importance of these studies, certain areas of the history of medicine in Ottoman Egypt particularly that of medical practitioners, still requires more in-depth research. As has been pointed out, there is a tendency amongst historians of medicine in Muslim societies to focus only on the careers and writings of prominent physicians and the great institutions in which they practised medicine, with the aim of highlighting the important position that medicine and science occupied in Islamic society.7 With the exception of a few revisionist studies, historians have rarely questioned whether these well-known theoretical writings influenced hands-on medical practice, and have ignored the majority of medical practitioners who maintained everyday contact with their patients.8 Unfortunately, some scholars have assumed that the organization of medical practitioners remained unchanged from the medieval period until the nineteenth century. In her study of the history of the Arab medical profession, Anne-Marie Moulin argues that, contrary to what happened in post fifteenth-century Europe where medical education and practice were regulated by medical faculties, there were no effective means of regulating medical practice in pre-modern Arab states because of the absence of equivalent bodies.9 Similarly, Sylvie Chiffoleau’s study of the nineteenth-century medical profession in Egypt suggests that the organization of pre-modern medical and paramedical craftsmen was rudimentary. Only barbers were organized in guilds, while the rest of medical practitioners, including physicians, were authorized to practise only after receiving an ijazāh, a certificate confirming that a student had mastered certain medical texts, and this was not an adequate means of ascertaining their ability to practise medicine.10 Yet, the evidence provided by records from law courts, manuscripts and other primary sources demonstrates that physicians, surgeons, oculists, bonesetters, barber-surgeons, apothecaries and midwives were all organized in guilds in Ottoman Egypt. This study aims to examine the extent to which the medical guilds played a role in the professional regulation of the medical practice of their members, supervised apprenticeship, and promoted work values among their members regardless of religious belief. But, as will be shown, despite their best efforts the medical guilds did not have total control over medical practice. The plurality of the medical system made this impossible. The lack of consensus on where medical authority lay is reflected in the large number of medical healers who acquired their knowledge and skills through a variety of ways, and who employed interchangeably different sources of medical knowledge: Galenic, prophetic, astrological, magical and folk medicine, for the treatment of their patients.