History of Medicine in Iran: Contagious Diseases and Its
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ARCHIVES OF ArchiveArch Iran Med.of SID June 2020;23(6):414-421 IRANIAN doi 10.34172/aim.2020.37 http://www.aimjournal.ir MEDICINE Open History of Medicine in Iran Access Contagious Diseases and its Consequences in the Late Qajar Period Mashhad (1892–1921) Jalil Ghassabi Gazkouh; PhD1, Hadi Vakili, PhD1; Seyyed Mehrdad Rezaeian, MA2; Seyyed Alireza Golshani, PhD1,3; Alireza Salehi, MD, MPH, PhD3* 1Department of History, Dr. Ali Shariati Faculty of Letters and Humanities, Ferdowsi University of Mashhad, Mashhad, Iran 2Department of Food Hygiene and Aquatics, Faculty of Veterinary Medicine, Ferdowsi University of Mashhad, Mashhad, Iran 3Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran Abstract One of the historical periods of Iran that can be studied for contagious diseases and how they spread, is the late Qajar period. The city of Mashhad, after Tehran and Tabriz, had a special place among Russian and English governments in the Qajar period as one of the significant religious, political and economic centers in Iran due to Imam Reza’s holy shrine, a large population and great geographical scale. The central governments’ incompetence in preventing the outbreak of contagious diseases and lack of essential amenities, caused many lives to be lost all over Iran and especially Mashhad during the Qajar period. Hence, the neighbor governments such as Russia, ordered for quarantines to be set up at the borders and dispatched doctors to stop diseases’ from reaching Russian lands. However, these attempts did not prevent the deaths of people in the border areas, especially in Mashhad, from diseases such as cholera, plague, smallpox, typhus, flu and other diseases. In this study, we investigate and explain the subjects: disease outbreaks, the problem of commerce, quarantine and its outcomes at the end of Qajar period, between the years 1892 and 1921 AD in Mashhad, with the help of historical and documentary sources using an analytical and medical historiography method. Keywords: Ancient, Disease Outbreaks, Quarantine, Iran Cite this article as: T. Contagious diseases and its consequences in the Late Qajar period Mashhad (1892–1921). Arch Iran Med. 2020;23(6):414–421. doi: 10.34172/aim.2020.37. Received: October 15, 2019, Accepted: December 21, 2019, ePublished: June 1, 2020 Introduction its consequences between the years 1897 and 1921. Medicine went through fundamental changes during the Mashhad, as the capital of Khorasan province, was one Qajar period. Hence, we can divide it into two periods of the major cities in northeast Iran. Due to its geopolitical, in terms of Iranian medicine and its changes: The first economic, cultural and pilgrimage status in the late Qajar one beginning from the dawn of the Qajar reign and period, it was a point of interest to the great powers of continuing for a few years after Naser al-Din Shah’s reign. the region such as Russia, Britain, Afghanistan and India. In this period, Iranian medicine is practically the old style From the early Qajar period, during Fath-Ali Shah Qajar’s of medicine practiced by Ibn Sina and Razi (Galen) with reign (1797-1834) and after the treaty of Turkmenchay in of course minor changes employed over time.1 The second February 21, 1828, the Russian empire became interested period began in the midst of Naser al-Din Shah’s reign in eastern Iran; during the reign of Naser al-Din Shah Qajar and continued until the Persian Constitutional Revolution (1848-1896), the Russian Empire caused Turkmenistan, during which the modern medicine gradually entered the Transoxiana and Chorasmia’s definitive separation from country and replaced traditional medicine; in other words, Iran.2 The circumstances in India were one of the main Galen’s and Ibn Sina’s medicine was replaced by Harvey’s incentives that attracted Russia’s interest in the eastern and Pasteur’s or modern European medicine. In the second regions of Iran and particularly Mashhad. After that, the period, scientific methods of treatment and other matters city attracted more attention from Russia due to economic regarding modern medicine began emerging in Iran by and political reasons.3 sending students to foreign countries, the establishment of Following this, the British government developed a Dar ul-Funun and health institutions, European doctors strong presence in Mashhad and Khorasan to prevent arriving in Iran and approval of the laws of medicine in Russia from infiltrating India. Mashhad was of particular the 2nd National Consultative Assembly (November 15, importance to the governments of Afghanistan and India 1909 to December 25, 1911).1 In this study, we discuss for political, pilgrimage and trade relations. Nevertheless, this second period with a focus on Mashhad and also the presence of Russian and British forces in Mashhad disease outbreak and the matter of trade, quarantine and posed economic, political and security problems to the *Corresponding Author: Alireza Salehi, MD, MPH, PhD; Associate Professor of Epidemiology, Research Center for Traditional Medicine and History of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran. Tel: +98-917-1127256; Email: [email protected] www.SID.ir Contagious Diseases in the Late Qajar Period Archive of SID people. Purchase, hoarding and export of raw materials flee and by hiding the truth, deceive the people and leave such as wheat and barley from Khorasan by Russian and them in the midst of chaos. The agents of the government British forces caused famine and consequently disease. would not inform other countries about the outbreak out Iran’s undeveloped state in the field of medicine, shortage of fear of road closures. They even opposed to establishing of experienced doctors, medical supplies and drugs needed a quarantine that required different expenses.7 in times of outbreak of contagious diseases in most cities, Furthermore, during the cholera outbreak, quarantine including Mashhad, had no result other than human stations were built between cities in Iran. For instance, catastrophes which will be discussed below. on August 10, 1918, the general consul of England in Mashhad, William George Grey, reports on the status of Disease Outbreak and the Matter of Commerce (Trade) cholera epidemic in Mashhad, “It has been three days since Mashhad had bad weather conditions. According to the cholera has appeared in Mashhad in such way that half available reports, Mashhad was not temperate in any of of the infected people die.” The English consul believed the four seasons. Winters were extremely cold and the that because too many travelers and traders travel from temperature would rise or fall every few days during spring Mashhad to Kerman and back, whenever cholera spreads and fall. Due to temperature change, rhinitis and malaria through Mashhad, it reaches Kerman within a few days. were very common in the winter; and summer had terrible In order to stop the contagion from Khorasan to Kerman, weather because of all the filth and sludge in the streets, quarantine stations must be set up in Darband Ravar and pathways and corridors.4 In 1892, there was an outbreak Bafgh districts, on the way from Khorasan and Yazd to of cholera in the Herat region. Despite the quarantine in Kerman.8 In times of an outbreak in a state, all the roads Bakharz and Taybad, sanitation officers could not prevent leading to that state were blocked by the order of the the spread of the disease to Mashhad. With this spread government and all the trading caravans and travelers had in May 15, 1892, some 20 000 people lost their lives in no choice but to travel through the routes specified by and around Mashhad.5 Haj Abulqasim Malek al-Tojjar, a the government. This issue had some negative effects on prominent Iranian merchant, writes about the outbreak commerce. Trading caravans had to travel only along the and business slack in Mashhad on January 20, 1892, “It assigned routes and were sometimes forced to travel very has been one or two months since cholera spread around long distances. Crossing these long roads led to lengthier Mashhad. People were in fear. The Mashhadis fled. transportation of merchandise for the caravans and more Trading was in a standstill state and no merchant was expensive products for the consumers.8 found who could do a trade worth of 100 dinars.” Malek Marvin L. Entner considered the outbreak of cholera in al-Tojjar also mentioned, “Nobody thinks about doing Iran and Russia from 1832 to 1835, as a main reason for business and trading in the city; there is no money here.” the decline in trade between Russia and Iran [Mashhad].9 He states that he stayed in the land for the purpose of On July 12, 1892, the cholera disease that was epidemic commerce, earning 10 tomans of money. Survivors from in Afghanistan reached Khorasan and Mashhad through the disease were so busy with mourning and prayer that Herat and killed many people in Mashhad in one month. had no time for trade.6 Cholera in other countries and Afterwards, the disease found its way to Tehran through lands beyond the borders also caused many problems for Shahroud. About this event, Joannes Fauvrier (1842- Iranian businessmen.6 1895) writes, “No action was taken by the government Cholera was considered as one of the epidemic and to ‘confront and prevent contagion’ of the disease which dangerous diseases in the Qajar period; it once again had spread across Khorasan,10 and due to the cholera spread through Mashhad and Khorasan from July 11 to outbreak in Iran, trading suffered an awful shock, business September 3, 1904.5 This lethal disease, also known as and businessmen were put in distress all over the country11 “Maraze-Mout” or “Margamargi” (meaning death disease), (Figure 1).